The ‘straight to test’ initiative reduces both diagnostic and treatment waiting times for colorectal cancer: outcomes after 2 years

Mukherjee, Samrat Kumar; Fountain, Gary; Stalker, Margaret; Williams, John; Porrett, T. R. C.; Lunniss, Peter J.

doi:10.1111/j.1463-1318.2009.02182.x

Cited by 23 publications

(31 citation statements)

References 10 publications

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“…A similar decrease was noted when LGIT 2WW referrals were analysed in isolation (99.9% in 2009 to 92.6% in 2014, p=0.02). In 2014, the median time from referral to the first clinic appointment for LGIT 2WW patients was 11 (interquartile range (IQR), [8][9][10][11][12][13][14] days. Proportion of patients diagnosed with CRC who breached the 62-day target for treatment was 20.1% in 2014 and 40.3% in 2012, with no significant overall trend (p=0.54).…”

Section: Resultsmentioning

confidence: 99%

“…Implementation of a 'straight to test' pathway has been shown to reduce waiting times to the diagnosis and treatment in patients with colorectal disease, and appears to be popular among patients. 11,12 This strategy may reduce the burden on outpatient clinics, but the challenge of providing timely investigation and treatment remain. As such, this approach may not be a panacea for the challenges to secondary care resulting from the trend towards increased numbers of 2WW referrals.…”

Section: Discussionmentioning

confidence: 99%

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Trends in urgent referrals for suspected colorectal cancer: an increase in quantity, but not in quality

Vulliamy

McCluney

Raouf

et al. 2016

annals

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INTRODUCTION An understanding of the volume of incoming referrals to a colorectal cancer (CRC) service is essential for adequate delivery of service. We hypothesised that the number of 2-week-wait (2WW) referrals has increased over recent years, with a concomitant increase in demand for endoscopic and imaging investigations. METHODS A retrospective review of all referrals from primary care with suspected malignancy to Barking, Havering and Redbridge NHS Trust (BHRNHST, London, UK) from 2009 to 2014 was undertaken. Annual numbers of CRC diagnoses, colonoscopies and CT scans among these patients were reviewed. Linear regression models were used to determine the significance of observed trends. RESULTS Annual number of 2WW referrals for all cancers increased steadily from 14,031 to 19,983 during the study period (p<0.01). Referrals for suspected CRC increased from 1,706 to 2,874 (p=0.02). Number of colonoscopies and CT scans carried out in 2WW patients also increased significantly. Proportion of patients referred as a 2WW diagnosed with CRC decreased from 7.9% in 2009 to 4.7% in 2014 (p=0.02). DISCUSSION Number of referrals for suspected cancer from primary care to BHRNHST is increasing steadily, which has implications for service provision. Prevalence of cancer diagnoses from these referrals is decreasing. CONCLUSIONS There has been a sustained and substantial increase in the number of urgent referrals for suspected CRC at BHRNHST over recent years, without an increase in the number of resulting cancer diagnoses.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Trends in urgent referrals for suspected colorectal cancer: an increase in quantity, but not in quality

Vulliamy

McCluney

Raouf

et al. 2016

annals

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“…They recommended that all patients referred from their general practitioners must be reviewed by a specialist within 2 weeks and must be offered treatment within 62 days (Mukherjee et al ., 2010) 4. This initiative has since been extended and rolled out to include other cancers and public health issues of interest in the UK (Lewis et al ., 2005) 5.…”

Section: Introductionmentioning

confidence: 99%

“…In June 2004, the UK National Health Service (NHS) introduced the 18 week patient pathway, which guaranteed that no patient should wait for more than eighteen weeks before any planned (elective) surgery in the UK (Bruni et al ., 2010) 6. This has resulted in a significant improvement in the early diagnosis and treatment of patients referred from their general practitioners (GPs), especially in the fields of oncology, orthopaedics, general surgery, rheumatology and cardiology, among others 123456…”

Section: Introductionmentioning

confidence: 99%

The surgical waiting time initiative: A review of the Nigerian situation

Abdulkareem

2014

Niger Med J

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SUMMARYThe concept of surgical waiting time initiative (SWAT) was introduced in developed countries to reduce elective surgery waiting lists and increase efficiency of care. It was supplemented by increasing popularity of day surgery, which shortens elective waiting lists and minimises cancellations. It is established in Western countries, but not in developing countries like Nigeria where it is still evolving. A search was carried out in Pub Med, Google, African journals online (AJOL), Athens and Ovid for relevant publications on elective surgery waiting list in Nigeria, published in English language. Words include waiting/wait time, waiting time initiative, time to surgery, waiting for operations, waiting for intervention, waiting for procedures and time before surgery in Nigeria. A total of 37 articles published from Nigeria in relation to various waiting times were found from the search and fulfilled the inclusion criteria. Among them, 11 publications (29.7%) were related to emergency surgery waiting times, 10 (27%) were related to clinic waiting times, 9 (24.3%) were related to day case surgery, 2 (5.5%) were related to investigation waiting times and only 5 (13.5%) articles were specifically published on elective surgery waiting times. A total of 9 articles (24.5%) were published from obstetrics and gynaecology (OG), 7 (19%) from general surgery, 5 (13.5%) from public health, 3 (8%) from orthopaedics, 3 (8%) from general practice (GP), 3 (8%) from paediatrics/paediatric surgery, 2 (5.5%) from ophthalmology, 1 (2.7%) from ear, nose and throat (ENT), 1 (2.7%) from plastic surgery, 1 (2.7%) from urology and only 1 (2.7%) article was published from dental/maxillofacial surgery. Waiting times mean different things to different health practitioners in Nigeria. There were only 5/37 articles (13.5%) specifically related to elective surgery waiting times in Nigerian hospitals, which show that the concept of the SWAT is still evolving in Nigeria. Of the 37, 11 (24.5%) publications were from obstetrics and gynaecology (O & G) alone, but these were mostly related to emergency antenatal care rather than surgery. Therefore, more research and initiative needs to be undertaken from all the surgical sub-specialties in order to disseminate this concept of SWAT towards early diagnosis and treatment of elective life-threatening conditions, as well as effective patient care. Adopting this concept will help healthcare managers and policy makers to stream line and ring face resources to cater for non-urgent or semi-urgent cases presenting to our hospitals in Nigeria.

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“…[4][5][6][7] Most systems are, however, reliant on the symptom dataset indicated in the referral proforma or letter from primary care, which are neither universally complete nor reliable. The 'Choose and Book' initiative was introduced to give the patient choice of the date and time of appointment and increase the involvement of patients in their healthcare.…”

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confidence: 99%

Clerically Delivered Triage of Colorectal Referrals: Does it Work?

Raghavendra¹,

Chitsabesan²,

Waydia³

et al. 2012

Bulletin

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The ‘straight to test’ initiative reduces both diagnostic and treatment waiting times for colorectal cancer: outcomes after 2 years

Abstract: STT speeds up the patient pathway by reducing the time to diagnosis and treatment for patients with CRC.

Cited by 23 publications

References 10 publications

Trends in urgent referrals for suspected colorectal cancer: an increase in quantity, but not in quality

Trends in urgent referrals for suspected colorectal cancer: an increase in quantity, but not in quality

The surgical waiting time initiative: A review of the Nigerian situation

Clerically Delivered Triage of Colorectal Referrals: Does it Work?

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