Nationally, 2-week wait (TWW) referral rates are increasing. Thisis reflected locally, with no corresponding rise in numbers of newcancers diagnosed. In May 2018, in collaboration with local generalpractitioners (GPs), we redesigned our pathway to enable speedierdiagnosis and reassurance.First, the referring GP requests computed tomography (CT) of thechest/abdomen and blood tests, at the same time as electronicallybooking a TWW telephone appointment (OPA) with a respiratoryconsultant. Initially local GPs were reluctant to book the CT as theydid not want the responsibility for chasing and acting on the results,but agreement was reached and the request form now stipulatesthat the trust are responsible for this.At the telephone appointment a history is taken, and the CTresults and initial investigative plan is explained. At this point thosewith no cancer can be reassured and discharged. Suitable patients,judged by performance status (PS) and comorbidities, are then sentdirectly to test or seen face-to-face (F2F) to assess fitness level, or ifthe patient is felt not to have fully grasped all the issues and needsfurther explanation.
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