Effective Cancer Management: framework

5. Optimal Referral

Ensuring a patient is on the right pathway at the right time is essential to ensure those at higher risk of cancer are seen and treated as quickly as possible. This is also essential for those who do not have cancer, so they and their families receive reassurance timeously.

5.1 Timed cancer pathways should be co-produced with primary and secondary care Teams and signed off by the Clinical Lead for each tumour group and should be reviewed annually (as a minimum) to ensure all emerging innovations and treatments are reflected.

5.2 Each step on the cancer pathway should be monitored closely by the tracking team and Cancer Manager to ensure patients are managed within agreed timescales from referral to treatment.

5.3 Direct access for Primary Care to diagnostics with appropriate national and locally agreed referral processes must be in place.

5.4 Processes for Advanced Nurse Practitioners (ANP) and Allied Health Professionals (AHP) should be available to allow USC referrals to secondary care.

5.5 Secondary Care should consider all appropriate USC referrals that meet the Scottish Referral Guidelines (SRGs) for Suspected Cancer from the Primary Care Team.

5.6 The use of Cancer Educational Platforms, in Primary Care, will help ensure the patient is directed to the right pathway.

5.7 Work with third sector organisations, such as Macmillan Cancer Support Scotland and Cancer Research UK, to maximize the use of their well-established training packages.

5.8 Boards and Primary Care should consider measurement of referrals and the number of regraded referrals as this will show opportunities for improvement.

5.9 All patients must be explicitly informed, at the point of referral, that there is a suspicion of cancer and that this is the reason for referral for diagnostic testing or to secondary care unless there is serious concern about causing unwarranted distress.