New services to help find cancer sooner

A new initiative to speed up cancer diagnosis and provide GPs with an alternative route to urgently refer patients has been launched.

Three Early Cancer Diagnostic Centres (ECDC), within existing NHS facilities, will help to pick up cancer earlier where patients do not meet referral guidelines.

The centres, being delivered through the National Centre for Sustainable Delivery, will provide GPs with an alternative route to urgently refer patients who have non-specific symptoms suspicious of cancer, such as weight loss, fatigue, pain and nausea, or where the doctor’s instinct is that cancer may be involved.

Centres in Ayrshire & Arran, Dumfries & Galloway and Fife will play a key role in delivering earlier diagnosis and improved care, with fast-track diagnostic testing at one appointment, where possible. NHS Ayrshire & Arran and NHS Fife aim to diagnose or rule out cancer within 21 days of diagnosis, while NHS Dumfries & Galloway is working towards an ambitious 7-day turnaround. 

Currently, around 40% of cancer patients in Scotland are diagnosed by routes other than by an urgent suspicion of cancer (USC) referral. Patients presenting with non-specific symptoms can be more difficult to diagnose as some symptoms, or combinations of symptoms, can have a range of potential causes, not all of which are cancer. Where cancer is the cause, the increased time taken to diagnose these patients can often result in poorer outcomes.

Under this new model, as well as an examination and suite of tests performed in primary care at the point of referral, patients will largely be sent for a CT scan in the first instance with all results discussed by a team of specialists at the hospital. All patients will be assigned a ‘navigator’ to support them throughout their experience and to answer any questions or concerns they, or their families, have at any time.

Health Secretary Humza Yousaf said:

“The establishment of our first Early Cancer Diagnostic Centres within the first 100 days of this new term marks a radical change to the patient experience of being tested for a suspicion of cancer and will improve the detection of cancers at an earlier stage.

“This person-centred service will mean better care for patients, reducing the number of hospital visits they might otherwise need, preventing them having to repeat diagnostic testing and improving outcomes.

“While the centres will have a wider health benefit in identifying other, serious health conditions, the focus remains on finding cancer as early as possible when it’s easier to treat. The centres reinforce our commitment to improving the experience and outcomes of cancer patients in Scotland and build on the progress of our £43 million Detect Cancer Early Programme.”

Lorraine Sloan, Strategic Partnership Manager at Macmillan Cancer Support, said:

“We welcome the introduction of the Early Cancer Diagnostic Centres. Getting referred for tests to check for cancer can be a worrying time. These centres should help people navigate their way through and get support quickly too.

“For those who do get diagnosed with cancer we know this can affect people physically, emotionally and financially, so early support is vital to ensuring people’s wider needs are met.

“Anyone concerned about cancer or who has been diagnosed with cancer can get support from Macmillan Cancer Support on 0808 808 00 00.”

Background

• The Scottish Government’s Cancer Recovery Plan ‘Recovery and Redesign: Cancer Services - Action Plan’, published in December 2020, committed to establishing at least two Early Diagnostic Cancer Centres by Spring 2021.

• Clinics are already up and running in NHS Dumfries & Galloway, where the first one was held on 24 May and Fife which opened on 7 June, to be followed by NHS Ayrshire & Arran on 21 June.

• Each board will introduce its own distinct pathway in a phased approach, with capacity increasing in line with patient need.

• The Early Cancer Diagnostic Centres pilot will run for an initial 12-month period, with ongoing independent evaluation throughout to identify optimal components of the model to inform wider rollout across NHS Scotland.

• At the end of the new pathway, patients will be referred onward to the most appropriate specialist team, to a site-specific cancer pathway, or discharged back to their GP practice.

• Patients who meet the Scottish Referral Guidelines for Suspected Cancer will continue to be referred through existing site-specific pathways

• The National Centre for Sustainable Delivery has been set up and commissioned by the Scottish Government and is hosted by NHS Golden Jubilee. It has been responsible for the design and development of the ECDC initiative and planning for its implementation across NHS Scotland.

• Cancer Research UK’s Clinical Engagement Team and Macmillan Cancer Support is offering navigators education and training opportunities while supporting in the development of quality patient resources and surveys, to ensure the service is truly person-centred and evolves to meet local patient demands over time.