Colorectal Cancer Straight to Test Pilot Mr Dimitrios Pissas Mr - - PowerPoint PPT Presentation

Mr Dimitrios Pissas Mr Praminthra Chitsabesan Adam Spray Ben Douglas Suzanne Bennett

Colorectal Cancer Straight to Test Pilot

Context

• Preparation for 28 day faster diagnosis standard
• Requirement to work towards national best

practise pathways

Analysis of Current Pathway & Performance

Referrals increasing since 2014 – from 2500 for the trust to 5000

Current 28 Day Performance

Current 62 day performance

Where we need to be by 2020

Overall Results of STT Pilot

Decision Making Analysis

• 50 triaged 0-1day (65%)
• 27 triaged 2-4 days (35%)

Referrals 77 Patients FT Clinic 22 patients STT Endoscopy 45 Patients STT CT Scan 7 Patients Consultant Triage Admitted prior to first contact 3 Patients Diagnosis 68 Patients Attrition 6 patients

Overall Results: Control Sample vs STT

Old pathway First Contact Clock Start to Endoscopy Done Clock Start to CT Report Clock Start to Diagnosis (28 day standard) Old Pathway Median 11 20 36 50 New Pathway First Contact Clock Start to Endoscopy Done Clock Start to CT Report Clock Start to Diagnosis (28 day standard) Total Pilot Median 14 13 33 33

Straight to Test (STT) Pilot

• The current trial will involve a telephone triage
• f the patient to assess what information is

missing from the form and to see if the form is fit for purpose

• Pnts will be triaged STT or to a fast track clinic
• (CT/ Ctcolon/Colonoscopy/Flexible sig)

Implementation in the future

GP Support

GP Referral Form

New Referral Proforma

Referral Proforma – Patient Demographics

Essential to ensure correct identification of patient. Please ensure Contact Telephone numbers are up- to-date.

Referral Proforma – Patient Suitability Confirmation

***Referring GP required to assess patient suitability for telephone assessment at time of referral and confirm on proforma.***

• Is the patient able to independently answer questions regarding their PMH

and presenting symptoms/complaint?

• Does the patient have a disability which may be a barrier to telephone

assessment?

Referral Proforma – Reason for referral

In accordance with NICE Guidelines for recognition and referral of suspected lower GI cancer.

Referral Proforma – Clinical Examination

***Comprehensive abdominal and digital rectal examination by GP essential as patient may not be assessed in person by a senior clinician following referral***

Please use tick boxes provided if examinati

• n

findings normal. Please record any abnormal findings, in as much detail as possible, using the tick box diagrams and spaces provided.

Referral Proforma – Referral Checklist

GP or Surgery admin clerk must ensure this section is fully completed and corresponding information is included in the referral. ***Missing information will result in patient not being recruited to pilot and potential delays to investigations, diagnosis and treatment.***

Any Questions?