Earlier and faster diagnosis

Rapid Diagnostic Centre (RDC) pathways

Diagnosing people earlier and faster means that patients have more treatment options, making it more likely that their cancer can be cured.

The Rapid Diagnostic Centres programme is in its third year of a five year transformational programme They are being implemented so that every cancer patient gets the right tests at the right time in as few visits as possible They will be the default way of diagnosing all cancers by 2024.

Cancer Alliances completed their 2021/22 planning focusing on applying the RDC principles to challenged pathways and increasing Non Specific Symptom pathways to achieve a minimum of 50 population coverage, with most Cancer Alliances planning to exceed that level this year.

In May, the Cancer Programme held a collaborative event for Cancer Alliances on ‘The Future of RDCs’, providing an opportunity for sharing learning.

The programme also hosted workshops in areas of leadership, sustainable workforce and commissioning models and innovations

The events attracted speakers from CRUK, the King’s Fund and wider system partners alongside RDC leads and were well attended by system leaders.

Local systems are making good progress in releasing diagnostic capacity across the system As of June 2021 there are 91 RDC pathways live with 1,373 cancers diagnosed cumulatively since May 2020.

In March, the South East London RDC team won the HSJ Integrated Care Pathway of the Year Award for their work’s benefit to patients The Guy’s Rapid Diagnostic Clinic was designed by primary care, secondary care, SEL Cancer Alliance, commissioners, NHS London and patients.

The service provides an integrated fast track diagnostic service for patients with vague symptoms.

Greater Manchester, in collaboration with the RDC team in Northern Cancer Alliances, were one of the finalists for the Cancer Care Initiative of the Year.

Faster diagnosis standard

The Faster Diagnosis Standard is being introduced so patients have cancer diagnosed or ruled out within a maximum of 28 days from referral From October 2021 cancer systems will be required to meet this standard for at least three quarters (75%) of patients.

We began publishing monthly 28 Day Faster Diagnosis Standard (statistics in June 2021 for the first time (showing figures for April), showing that 72.9% of patients are  receiving a diagnosis or ruling out of cancer within 28 days. We have produced best practice timed pathways to show how effective care can be provided within maximum target times to meet this standard.

Targeted lung health checks

Lung cancer causes more deaths in the UK than any other cancer, due to sufferers often experiencing no signs or symptoms when the disease is in the early stages.

Aiming to identity issues early, when there are better options for treatment and a higher chance of survival, the (TLHC) Programme offers lung health checks to current or former smokers aged 55 to 74.

Other lung conditions can also be identified through TLHCs, and participants are transferred on for relevant treatment and care.

The pilot programme started in England in 2019 rolling out in phases across areas with among the highest rates of lung cancer in the country.

After some disruption caused by the pandemic, the first six months of 2021 has seen a widespread restoration of programmes of the 23 phase one and two sites, 20 are now live with the remaining three set to be fully operational by September.

A third phase is anticipated later in 2021 which will see further places go live by next April.

The initiative will diagnose an estimated 9 000 cancers and increase the proportion of lung cancers in these areas caught at stage 1 or 2 from 28 to two thirds, offering the opportunity for more and earlier interventions, including curative surgery, which will save people’s lives.

Advice on stopping smoking will also be offered to thousands of current smokers.

We have created a TLHC toolkit which has been sent to all Cancer Alliances to help them encourage uptake among their local populations.

Cancer Screening – Deborah Tomalin, Director of Public Health Commissioning and Operations

All our NHS Cancer Screening service providers have worked so hard to ensure delivery and restoration of our screening services during the pandemic. Collective efforts to more closely integrate screening services with diagnostic and treatment services is at the heart of improving the experience of those invited for screening.

NHS Cancer Screening programmes have continued in the latest wave of the COVID pandemic, despite some providers being under pressure.

During the first wave of the pandemic, NHS England and NHS Improvement did not issue a national directive to pause screening services. However, many local screening providers made the decision that they needed to reschedule routine appointments and invitations to a later date to protect patients and enable staff to be redeployed.

Through the latest waves of COVID, providers have all managed to continue with provision with one or two temporary exceptions agreed with regional public health commissioning teams.

Breast screening

Some local breast screening services were paused by providers as a consequence of the pandemic, screening of higher risk women has continued throughout.

We’re investing £22 million to support COVID secure adjustments to breast screening units to keep patients safe and £50 million to build recovery capacity with a national restoration recovery plan to restore to a 36 month round length by March 2022.

Our national restoration and transformation plan is in place to support regions including initiatives on workforce and training, data, and IT.

Bowel screening

All five bowel screening hubs are issuing routine invitations with the rate of invitations being sent across the country above pre-pandemic levels to aid recovery.

Following a recommendation from the UK National Screening Committee, agreed by the Health Secretary, bowel scope screening was formally decommissioned in December 2020 to instead expand the home Faecal Immunochemical Test (FIT) testing programme.

From April 2021, we began a phased approach to widen the population eligible to receive a FIT test to include 50 to 59-year-olds starting with those aged 56 years.

Cervical screening

GP surgeries and health centres have continued to offer cervical screening, with special measures in place to protect patients from COVID.

Since January 2021 the volume of samples that have been sent to the laboratories for testing have been above pre-pandemic levels. Colposcopy services have been expanding their capacity to increase activity and manage rising demand.

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