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From 1 October 2023, the standards for measuring waiting times for cancer diagnosis and treatment are being modernised and simplified. The NHS is moving from the 10 different standards currently in place to three: 

• Faster Diagnosis Standard: A diagnosis or ruling out of cancer within 28 days of referral (set at 75%). 
• 31-day Treatment Standard: Commence treatment within 31 days of a decision to treat for all cancer patients (set at 96%). 
• 62-day Treatment Standard: Commence treatment within 62 days of referral or consultant upgrade (set at 85%). 

The main changes are: 

• Removal of the Two-Week Wait standard, which required a first appointment within two weeks. 
• Combining the first and subsequent 31-day treatment standards to create one headline performance standard. 
• Combining the Urgent Suspected Cancer GP referral, Urgent Screening, and Consultant Upgrade 62-day standards to create one headline performance standard for all patients. 

Note: There is no change to the way GPs refer patients onto Urgent Suspected Cancer pathways. The only change is that the NHS will now measure the speed of diagnosis rather than whether the patient has had a first appointment within two weeks. 

More information for GPs is available on the NEL Cancer Alliance webpage and the NHS England » Cancer page. 

NEL cancer alliance webpage. 

NHS England » Cancer 

2WW/ Pan-London Urgent Suspected Cancer Referral Forms 

In January 2023, revised Pan-London Urgent Suspected Cancer (USC) referral forms were published (previously known as Two-Week Wait referrals). 

The revised forms aim to better promote the inclusion of key information on the reasons for USC referral and ensure all necessary information is included for triage and rapid assessment by the receiving hospital. 

Forms can be found on the Pan-London Suspected Cancer Referral Forms - Transformation Partners in Health and Care Partnership page. Transformation Partners have also created several "Top Tips" documents to support primary care physicians. 

Pan-London suspected cancer referral forms - Transformation Partners in Health and Care Partnership 

Top tips documents to support primary care physicians.  

Tumour-specific top tips: Breast, Lower GI, Upper GI, Gynaecological, Haematology, Sarcoma and Urology. (Head and Neck, Lung and Skin coming soon) 

Multidisciplinary Rapid Access Diagnostic Centre (MRADC) (bartshealth.nhs.uk) 

For patients who do not fit the NG12 tumour group 2WW pathway ,please consider using the Rapid Diagnostic Clinic at the Royal London Hospital.  

 Search code for the form on EMIS is RP Multidisciplinary Diagnostic Centre Referral Form.rtf 

This clinic is aimed at patients presenting with vague but concerning symptoms that could indicate cancer. Therefore, patients who present with the following should be referred directly to the MRADC:  

• Vague symptoms that do not meet any of the tumour specific two-week wait pathway  
• Symptoms that identify two or more two-week wait pathways  
• Abnormal imaging that is suspicious of cancer.  

We ask that all patients referred to the service have an up-to-date renal function completed (within 3 months) in addition to the following:  

• FBC  
• U&Es  
• Bone profile  
• LFTs  
• HbA1c  
• TFTs  
• CRP  
• An HIV test should be considered where appropriate.  
• FIT test: this can only be arranged in the community so please ensure it is done prior to referral 

Where appropriate please also consider arranging the following   

Urinalysis  

CA125/ PSA   

Coeliac antibodies  

faecal calprotectin   

lipase   

Gamma GT  

chest x-ray  

Abdominal and pelvic ultrasound  

Referrals can be made directly through the NHSE referral service by selecting "2WW Multidisciplinary Rapid Access Diagnostic Clinic (RLH) – Barts Health NHS Trust – R1H," found under 2WW and Cancer of Unknown Primary. 

Primary Care | North East London Cancer Alliance 

Primary Care | North East London Cancer Alliance (nelcanceralliance.nhs.uk) 

The NEL Cancer alliance has several sections to support the current PCN DES and QOF work.  

Under the section Healthcare Professionals → Primary Care → PCN DES, there are resources available to support PCN DES and QOF work, including: 

PCN DES and QOF Support Guide   

Quick Wins Checklist,   

NEL-wide Cancer Updates 

These can be found under the section Healthcare Professionals → Primary Care → Primary Care News. 

CEG toolkit  

Cancer toolkit - Clinical Effectiveness Group (qmul.ac.uk) 

The CEG Cancer Toolkit  

The CEG Cancer Toolkit supports GP practices in working smarter and reducing avoidable delays in cancer diagnoses. 

The toolkit is available on the CEG website under Support for Practices → Resources → Cancer Toolkit. 

These resources include: 

Audit tool 

Referral and safety netting template 

Searches and dashboard 

All of these are supported by assistance from CEG facilitators. The resources are available to practices across North East London to help them work efficiently, simplify safety netting procedures, and review and reduce inequalities in cancer referrals, follow-ups, and care. 

Safety netting  

It is important that all cancer referrals and urgent investigations, including blood requests, FIT tests, imaging, and direct access, are followed up at appropriate time intervals. 

The RP Cancer Safety Netting Template can assist in this process. 

Other useful resources include: 

Pan-London-Suspected-Cancer-Safety-Netting-Guide-May-2023.pdf (transformationpartners.nhs.uk) 

Safety netting | Cancer Research UK