Cancer survival rates in England are higher than they have ever been and earlier diagnosis is a key part of improving survival rates further.
The NHS Long Term Plan continues to expand upon work to transform cancer care so that from 2028, an extra 55,000 people each year will survive for five years or more following their cancer diagnosis, plus three in four cancers (75%) will be diagnosed at an early stage.
Earlier diagnosis is critical to meeting this ambition, as it means patients can receive treatment when there is a better chance of achieving a complete cure.
By providing dedicated focus and capacity, the Alliance is working to drive forward change in order to deliver improvements in cancer outcomes locally. Humber, Coast and Vale Cancer Alliance is working with partners to develop and deliver strategic plans for radiology, pathology, and endoscopy services across the area. These plans include:
Rapid Diagnostic Centres
Rapid Diagnostic Centres (RDCs) are designed to speed up cancer diagnosis and support our ambitions to achieve earlier diagnosis, with improved patient experience, for all patients with cancer symptoms or suspicious results.
The Long Term Plan commits to the roll-out of new RDCs that bring together modernised kit, expertise and cutting edge innovation. To begin with, RDCs will focus on diagnosing patients with non-specific symptoms who may have previously gone to their GP many times before being sent for tests. Non-specific symptoms include unexplained weight loss and/or appetite loss, non-specific abdominal discomfort or pain, fatigue and unexplained sweats.
At the end of January 2020, the first RDC in Humber, Coast and Vale launched at York and Scarborough Teaching Hospitals NHS Foundation Trust. Since its launch, the service has seen over 100 patients and diagnosed 12 cancers.
The core principles of RDCs are to provide; coordinated access to a diagnostic pathway, accurate, personalised and rapid diagnosis through networked provision, and one urgent cancer referral in order to be diagnosed with cancer. The RDC approach contains seven key components:
The Alliance is now working with stakeholders to embed these principles and pathways across the HCV region, with developments currently underway across Hull University Teaching Hospitals NHS Trust and Northern Lincolnshire and Goole NHS Foundation Trust.
By 2024, all RDC pathways will offer a single point of access for all patients with suspected cancer by 2024. They will offer a personal, accurate and fast diagnostic service, with excellent patient experience.
An example of a patient’s experience of the RDC pathway at York and Scarborough Teaching Hospitals NHS Foundation Trust
Community Diagnostic Hubs
In order to reduce health inequalities and increase access to diagnostic services, the Alliance is working with partners to develop Community Diagnostic Hubs for our region.
Community Diagnostic hubs are multi-diagnostic facilities that are located away from hospital sites, including on the high street and in retail locations. The hubs provide quick and easy access to various diagnostic tests such as blood tests, x-rays, ultrasound, CT scans, and endoscopy.
Nationally, the NHS ambition is for each Integrated Care System to develop one Community Diagnostic Hub during 2021-22, and to have 3 hubs per million people by 2023.
Imaging and Endoscopy Networks
Networks and alliances bring together teams working in particular areas of healthcare, especially where some services cannot be delivered in all NHS trusts or where efficiencies can be achieved from cross-trust working.
One of the key drivers for imaging networks is to facilitate the sharing of images between providers. This will avoid duplication of imaging when a patient moves between hospitals and will also allow reporting to be done where there is spare capacity, including home reporting. In addition, complex interventional radiology may best be delivered in a small number of locations within a network.
For endoscopy, a network is being established in order to work together to assess capacity and demand; reduce the proportion of patients not attending or cancelling late; improve procurement; develop joint training; introduce centralised scheduling; offer patients choice of location for endoscopy; and centralise highly complex cases.
Digitisation and IT connectivity will be vital for networks to work efficiently. IT linkage between hospitals, all diagnostic hubs, and GP practices is vital for effective pathology and genomic services. Image sharing across networks will facilitate the efficient use of radiology staff for reporting. This should include linkage to allow home reporting of images. Digitisation is a necessary precursor to large-scale future use of artificial intelligence in the diagnostics field.
Our plans for diagnostic services are also shaped by and in line with national guidance, including:
Innovative and collaborative use of workforce
To ensure we have the right number of skilled staff in order to provide high-quality care and services, the Alliance is supporting the NHS Cancer Workforce Plan, which focuses on three key themes:
- 1. Development of new roles, including educators, clinical leadership roles, advanced care practitioners, and radiographers.
- 2. Improving access to training; working with Health Education England (HEE) to develop online training and review the types of degree courses that can be accessed.
- 3. Improving ways of working, including developing networks of practitioners, improving remote working, and utilisation of new technology to improve efficiency.