How to write and review an access policy in line with best practice for referral to treatment and cancer pathways

NHS Improvement | July 2018 | How to write and review an access policy in line with best practice for referral to treatment and cancer pathways

NHS Improvement have added resources to their elective care model access policy resources:

How to write and review an access policy in line with best practice for referral to treatment and cancer pathways here

This covers:

  • Why is an access policy important?
  • What is the purpose of an access policy?
  • Who should be involved in developing the policy?
  • What should you include or exclude?
  • What questions should the access policy address?
  • When should you review it?
  • What happens next?

Cancer app developed by GPs being trialled by CCGs

A GP-developed app aiming to help GPs navigate the tests and urgent referrals necessary for patients presenting with cancer symptoms is being trialled by two CCGs | Pulse


C the Signs was co-founded by newly qualified GP Dr Bhavagaya Bakshi and fellow doctor Miles Payling and quickly checks symptoms of more than 200 cancers against multiple diagnostic referral pathways.

Last week the app won the People’s award at the Tech4Good awards and is now set to be trialled with GPs in the East of England to test its real world cost and clinical effectiveness.

Read the full news story here

Immediate chest X-ray for patients at risk of lung cancer presenting in primary care

Neal, R.D. et al. (2017) British Journal of Cancer. 116, pp. 293-302

AS0000184F07 Hospital doctors looking at X-ray of lungs
Image source: Anthea Sieveking – Wellcome Images // CC BY-NC-ND 4.0

Background: Achieving earlier stage diagnosis is one option for improving lung cancer outcomes in the United Kingdom. Patients with lung cancer typically present with symptoms to general practitioners several times before referral or investigation.

Conclusions: We have demonstrated the feasibility of individually randomising patients at higher risk of lung cancer, to a trial offering urgent investigation or usual care.

Read the full abstract here

Patterns of Referral to Radiation Oncology among Patients with Bladder Cancer

Quirt, J. S. et al. Clinical Oncology. Published online: 6 November 2016
Image source: Wellcome Images // CC BY-NC-ND 4.0

Image shows photomicrograph of adenocarcinoma of the bladder


  • Guidelines support either cystectomy or radiotherapy for invasive bladder cancer.
  • This population-based study describes referral patterns to radiation oncology.
  • One third of patients with bladder cancer were referred to radiation oncology.
  • Only 10% of patients were seen by radiation oncology postoperatively.
  • Closer collaboration between radiation oncology and urology is warranted.

Read the abstract here

Cancer ratings


NHS England has published new cancer ratings providing a snapshot of how well different areas of the country are diagnosing and treating cancer and supporting patients. The overall rating for each clinical commissioning group is based on four indicators or metrics; early diagnosis, one year survival, 62 day waits after referral, and overall patient experience.

Additional links: NHS England news | BBC News report

Interactive summary of suspected cancer guidelines

Cancer Research UK and the Royal College of General Practitioners have launched a new interactive desk easel for GPs, which summarises the NICE referral guidelines for suspected cancer (NG12).

GPs can access the summary from their desktop computer and click through to the recommendations for each symptom group. Recommendations for adults, children and young people are covered, as well as primary care investigations.


image source:

Nurse-led telephone triage for people with suspected colorectal cancer

Crisford, M. et al. 2016. Cancer Nursing Practice. 15 (1) pp.18-25.

Image source: Carsten Knoch

The two-week rule was introduced to address delays in cancer diagnosis. It requires patients with suspected cancer to be seen by a specialist within two weeks of GP referral and has implications for colorectal departments in terms of managing demands on service provision.

In one NHS trust it was addressed by introducing a nurse-led telephone triage assessment to determine patients’ suitability for investigations before attending outpatient clinic. The assessment was developed by a Delphi survey. An audit evaluated whether time from referral to investigation had reduced since introduction of the assessment.

Data were collected retrospectively from 40 patients before its introduction and compared with 40 patients after its introduction. Time to investigation was reduced in the telephone assessment group: a mean of 12.5 days versus 21.2 days, with a mean difference of -8.7 days.

Introduction of telephone assessment reduced time from GP referral to investigation and enabled earlier detection of cancer in line with healthcare policy.

Read the abstract here