Developing Rapid Diagnostics

Diagnosing cancer as early as possible across South Yorkshire and Bassetlaw

By developing 'rapid diagnostics' our aim is to help diagnose people with cancer and other conditions as soon as possible by speeding up the time between first noticing signs and symptoms, seeking advice and being diagnosed – all leading to being treated sooner.

Together with expert clinicians across services, we are looking at what improvements could be made, how we could work differently or use new technologies so that people are supported to make appointments, are referred to the most appropriate service and are diagnosed with cancer, or the reassurance that they don’t have cancer, sooner.

We want to make services more person-centred; reduce the amount of appointments by having more same day, same location tests and a single, named contact for support throughout a person’s diagnostic journey.

By making services more efficient, not only do we help patients but we also improve ways of working for staff; improve communication between hospital specialists and primary care services and reducing waits and duplication.

We also hope to reduce health inequalities, which have been worsened by the Covid-19 pandemic, by supporting communities most affected by poor health to seek medical help, with clear communication and support to attend appointments, help understand their diagnosis and support them to agree a treatment plan.

The role of the SYB ICS Cancer Alliance in supporting the development of rapid diagnostics

The South Yorkshire and Bassetlaw ICS Cancer Alliance, working as part of the wider Integrated Care System, is leading on this work across Barnsley, Bassetlaw, Doncaster, Rotherham and Sheffield.

Around 90% of people referred for diagnostics do not have a cancer so by providing a faster diagnosis, we can remove the worry of cancer for many people earlier and ensure they are referred to the most relevant place for their care, treatment or condition management.

This is a five year programme and by the end of 2024/25 we aim to be providing faster diagnoses across each of our cancer services with some system-wide solutions where it makes sense to do so – for example, by exploring System-wide virtual ways of working, developing System-wide advice and guidance to support clinicians with referrals and decision making and supporting the development of Patient Navigator roles – people employed by each of our hospitals to provide individual support to people throughout their investigations and diagnosis.

Expert clinicians across cancer services – from primary care and our hospitals – are working together, as well as health and care staff from our five Places of Barnsley, Bassetlaw, Doncaster, Rotherham and Sheffield to support the delivery of rapid diagnostics.

All partners are working together as part of an RDS Development Group to share learning, insights and developments as the programme progresses.

What has happened at a System level so far? 

• A development group has been established by the Cancer Alliance and Place leads to take the work forward
• The South Yorkshire and Bassetlaw ICS Patient Advisory Board have been informed and involved throughout the process so far. So far, the Patient Advisory Board have been asked for feedback on the plans including the job description for the associated Patient Navigators, and invited to take part in semi-structured engagement interviews on a one to one basis to discuss the quality markers of the service and what good quality looks like to our members
• Within primary care the implementation of the C the Signs clinical decision support tool will help streamline the referral process and ensure people are referred to the most appropriate pathway and place
• In the Lower GI pathway, the use of FIT testing has been expanded as an assessment tool to significantly reduce those previously referred for more invasive tests based on their symptoms alone
• Non site specific rapid diagnostic pathways are in place, supporting GPs in making sure people whose symptoms are not obviously linked to a specific cancer type, get the right set of tests to find out more
• We are looking at patient information received at each part of the journey to make sure people understand their referral, the tests they will have and the importance of attending appointments

Next steps

There is some national funding available to support the programme. Funding allocation for this year (2021/22) has been guided by a set of agreed principles, one of which is ensuring that decisions are considered by the Patient Advisory Board. Other principles include ensuring transparent decision making, focusing on early diagnosis and reducing health inequalities, and acting in the spirit of collaborative working (as a System rather than as individual organisations or Places).

The areas currently identified for funding by Board are as follows:

• Additional clinical leadership across services, dedicated teams for priority joint rapid diagnostic services, more nursing capacity for the prostate pathway and continuation of recruitment for Pathway Navigator roles
• Support to surgical services in the form of trackers to make pathways run more smoothly for patients and staff
• A focus on supporting the process for those who don’t have symptoms obviously linked to a specific cancer type (non-site specific) – ensuring consistency across the region
• Resource to aid Covid-19 recovery such as temporary weekend contracts for certain staff roles so we can offer more appointments for people
• A patient App for improved at home support
• Funding multidisciplinary ‘teams’ to work together to set up new types of clinics to test new ways of working
• Ensuring we can track people throughout their journey – from referral, through to diagnostic and treatment