Bowel Cancer Framework for Scotland
Bowel cancer is an improtant health issue worldwide and, in Scotland, it represents a major problem. In this framework the key components of a national bowel cancer service programme are outlined.
BOWEL CANCER FRAMEWORK FOR SCOTLAND
03. RAPID ACCESS TO DIAGNOSIS AND TREATMENT
"To increase the probability of treatment success while at the same time minimising patient anxiety and stress, delays in investigation, diagnosis and subsequent treatment of cancer must be eliminated wherever possible." Cancer in Scotland: Action for Change (2001).
Feedback from patients has frequently confirmed that waiting for appointments to be seen at out patient clinics, waiting for appointments for investigations, waiting for results and waiting for treatment adds considerably to their anxiety and stress. Moreover, speed of access is considered to be one of the main reasons for dissatisfaction with the NHS. The Scottish Executive is therefore committed to a programme of national targets that are designed to alleviate patient and public concerns and to improve diagnosis and treatment services by driving down waiting times for everyone with cancer. Every part of the patient pathway, from referral, through investigation, diagnosis and subsequent treatment requires to be carefully examined and appropriate changes made to secure real and lasting improvements.
In planning to meet the target that, "By 2005, the maximum wait from urgent referral to treatment for all cancers will be two months", NHS Boards also need to take into account the possible impact of the introduction of a national bowel screening programme. Local Health Plans are a public statement of each Board's plans for their local health services. National waiting times targets are monitored and for the 2005 target systems are currently being put in place to assess performance against it.
In the three years since publication of Cancer in Scotland, 18m additional investment has brought significant reductions in waiting times across the country. However, to assist further an additional 1m, over and above that, has been invested in the Cancer Service Improvement Programme (CSIP) that aims to accelerate the pace of change and bring further improvements to existing systems and processes across the three regional cancer networks.
In both the West of Scotland and the North of Scotland CSIP facilitators are working with bowel cancer networks to look at further sustainable improvements that can be made across their respective regions. It is anticipated that services will be reorganised and/or altered in a variety of ways that will enhance patients' experiences and further reduce waiting times. A redesign programme is also underway in West Lothian.
As noted elsewhere in this framework, the provision of endoscopy/colonoscopy services and workforce shortages represent significant challenges both for symptomatic and for potential screening services. Waiting times for colonoscopy are variable across Scotland. Innovative approaches to the delivery of these services are required if the range and type of services required are to be delivered for patients and for the well population eligible for screening.
The Centre for Change and Innovation is planning to hold a national convention in September to facilitate clarification of, and consensus on, the immediate, medium- and longer-term priorities including options for increasing capacity and training provision within NHSScotland.
So as to avoid unnecessary duplication of effort and to ensure a collaborative approach, these are issues that need to be considered at three levels; locally, regionally and nationally involving clinicians, workforce planning and NHS Education for Scotland colleagues.
RAPID ACCESS TO DIAGNOSIS AND TREATMENT
What is required? |
What is already happening? |
Next steps |
Service Implications |
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Prompt, high quality investigations
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Endoscopy services
Endoscopy training
Redesign
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Service Implications |
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Robust Support Services, e.g. Radiology and Pathology
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Cancer in Scotland investment to pump prime a managed clinical network for pathology initially in North East Scotland - the aim is to extend the network across Scotland to facilitate, among other things, enhanced sharing of expertise and role redesign |
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