Effective Cancer management: framework

3. Initiating the Pathway

It is good practice to ensure that all USC referrals are vetted promptly and appointed for a consultation (be that in person or virtually) and/or investigation to take place within two weeks of receipt of referral. This will ensure the patient is directed to the right pathway as soon as possible.

3.1 Adopt ACRT (Active Clinical Referral Triage), ensuring that all referrals to secondary care (including advice and patient initiated referrals) are triaged by a senior clinical decision-maker to evidence-based, locally agreed pathways after reviewing all the appropriate electronic patient records.

3.2 Agree vetting standards with agreed timescales e.g. within 48 hours of receipt of USC referral.

3.3 The primary care clinician who has made the USC referral must be informed promptly that it has been regraded and the reason for the regrading. Referrals should only be regraded if not consistent with the Scottish Referral Guidelines for Suspected Cancer. The referrer should be given the opportunity to provide further information to support the original priority of the referral. Ensuring the patient is informed of any change in urgency of referral is key and this should be done through a locally agreed process.

3.4 Clinical teams should work with service managers to ensure that there is appropriate clinic and diagnostic capacity to meet USC demand.