Certainty and booked appointments
5.13 An important theme for the Collaborative will be ensuring that all patients with suspected cancer have information about what they can expect and when.
The steps along the pathway of diagnosis and treatment for different cancers are in large measure predictable and it is possible to plan and schedule these tests and treatments. The Collaborative has already begun to demonstrate how this helps to streamline the delivery of care, cuts down waits, and gives patients the certainty of having all the stages of a diagnostic or treatment process booked in advance. Arrangements for pre-booking appointments are being introduced across the NHS by 2005. But for cancer we can and should move faster. So the Cancer Services Collaborative will make booking of cancer services a priority as it rolls out across the country and by 2004 every patient diagnosed with cancer will benefit from pre-planned and pre-booked care.
"I feel, through my experiences of cancer, that if the waiting time for test results could be shortened, it would make a great difference. I have found that during this period it causes unnecessary worry, anxiety and depression."
Macmillan Cancer Relief
Open Space initiative
Early local targets
5.14 The Collaborative will ask networks to identify local bottlenecks and plan local improvements. So there will be an important emphasis, especially in the early stages, on local targets for improvement. It will also be important for networks and clinicians to look carefully at the experience of those patients who do have long waits, to identify the causes.
5.15 So the new clinical datasets that are being introduced (see Chapter 6) will include information, for each cancer patient who begins treatment, on the key dates along the pathway: the first GP referral, or other point of entry; the first out patient appointment; the date of decision to treat and the date of first treatment. This will enable clinicians to review cases which exceed local or national targets. There may have been a good reason for the wait, for example because of a particularly complex diagnostic path or because the patient chose to defer a step in the process, but this audit process will also help identify organisational problems that need to be solved.
