NEW FIT TEST & REFERRAL SYSTEM REDUCES DELAYS FOR CANCER PATIENTS

The situation

Bowel or Lower Gastrointestinal (lower GI) cancer refers to cancers of the large bowel (colon, rectum and anus) and is one of the most common types of cancer in the UK.

During the Covid-19 pandemic the NHS experienced delays across waiting lists due to pressure on hospitals.

This had a knock-on impact for cancer patients and nationally there was a reduction in the number of people seeing their GP with symptoms and being referred, diagnosed and treated for cancer.

To help combat these delays, NHS England released a national directive followed by guidance from the National Institute for Health and Care Excellence (NICE) enabling GPs to refer patients that display symptoms of colorectal cancer for a Faecal Immunochemical Testing (FIT). It is a non-invasive test that looks for blood in a sample of poo. The result and patient symptoms are reviewed, allowing patients with a high risk of colorectal cancer to be booked for timely appropriate diagnostic tests.

What we did

The Integrated Care Board (ICB) Cancer Transformation Team worked with the West Midlands Cancer Alliance,  Bowel Screening hub, Primary Care colleagues (GPs) and cancer specialists at University Hospitals Coventry and Warwickshire NHS Trust to identify how a new patient pathway could be developed featuring the FIT test. In addition, an automated referral process through a system call tQuest was introduced to improve the timeliness and accuracies of referrals. 

By introducing the FIT test and the new referral system patients are likely to have an earlier diagnosis and improved access to treatment. Key information is gathered by the patients GPs earlier on in their care journey and come patients will avoid invasive procedures such as colonoscopies or may not require referral into secondary care.

The outcome

Through the new process Primary Care now have access to FIT results within 12 days of requesting the test, supporting decision making to determine the next steps for patients.

From the point of GP referral into secondary care a high proportion of patients will receive notification that they do/do not have a cancer diagnosis within 28 days.

Speaking about the new process, Dr Hazel Blanchard, GP Partner at Forrest Medical Centre and Primary Care Clinical Cancer Lead at Coventry and Warwickshire Integrated Care Board, said:

"By knowing the FIT result when we refer from Primary Care it means we can better prepare the patient for the tests they may have. Patients are getting the right investigations they need sooner. So, if they don't have cancer, they get reassurance earlier and if they do have cancer, next steps in their treatment can start."

Moving forward the ICB Cancer Transformation Team is continuing to work closely with local acute hospital sites and Primary Care colleagues to improve other cancer pathways.