The West Midlands Cancer Alliance and The Royal Wolverhampton Hospital NHS Trust have implemented a nurse-led ‘fast track’ programme for suspected prostate cancer patients, via a telephone triage service.

The programme was introduced because of a dramatic increase of patient referrals in February 2018. This increase was attributed to increased media coverage and several celebrity diagnoses. The additional demand on services resulted in additional stress to the two-week wait referrals. In 2013/14 350 patients were seen in clinic, rising to 550 patients in 2017/18, an increase of 57%.

During the trial, Advanced Nurse Practitioners (ANPs) arranged telephone calls with patients referred into hospital via a two-week wait referral. The purpose of the telephone call was to decide the order of treatment, ensuring the best course of action for the individual patient.

The programme is being offered to appropriate patients who meet the specific requirements, allowing patients to go directly to test and biopsy prior to their outpatient appointment, therefore speeding up time to diagnosis.

Patients who’ve followed the new triage pathway have benefitted from a significant reduction in the average amount of time between referral and being seen in hospital:

• Average four days from referral to triage – previously 10 days
• Average 16 days referral to MRI – previously 33 days
• Average 27 days referral to transrectal ultrasound guided (TRUS) biopsy – previously 43 days
• Average 29 days referral to multi-disciplinary team review
• Average 30 days referral to diagnosis appointment or nurse telephone call

A patient satisfaction survey of all patients contacted over a six month period which shows very high levels of patient satisfaction.

Peter Cooke, Clinical Director and Urology Consultant at The Royal Wolverhampton Hospital Trust said:

“The NHS aims to give patients with suspected prostate cancer a diagnosis within 28 days of referral by 1 April 2020. The triage service is a major step in delivering this, with a faster, more convenient and better quality diagnostic pathway. A telephone assessment of the patients by our team of dedicated specialist nurses, followed directly by a prostate MRI or CT scan as a first step, has already proven to be a very rapid, effective and less stressful process.”

Robert Platt, a 63 year old heavy goods vehicle driver from Merry Hill in Wolverhampton was a patient in the telephone triage service last year. He said:

“A friend of mine recently had surgery on his prostate and advised me to get myself checked. After making an appointment I’d had an MRI scan, treatment and results were prompt all within one month. The treatment I received from everyone was excellent.”

Andrea Gordon, Managing Director of West Midlands Cancer Alliance said: “Community projects like this are proving successful in helping to tackle health inequalities – in this case, patients are diagnosed quicker and in hospital receiving treatment faster.”

In the NHS Long Term Plan, NHS England and NHS Improvement outlined its commitment to improving cancer survival and diagnosing cancer earlier is one of the biggest actions it can take to achieve this.