Abstract

Abstract Aim The NHS “Faster Diagnosis Standard” (FDS) recommends patients referred for suspected cancer to be diagnosed or have cancer ruled out within 28 days. Reducing time to diagnosis and treatment in head and neck cancer is associated with improved patient outcomes. Our aim was to improve compliance to the 28-day standard in a large tertiary head and neck department, by introducing a rapid-access clinic for head and neck lumps including same day ultrasound-scanning with biopsy. Method Data was collected in two rounds: 3 months before and after introduction of the rapid-access clinic in September-2022. Data collected included referral reason, time from referral to specialist review, to ultrasound, and to diagnosis. Patients not fitting agreed criteria for the clinic were excluded. Results In the first round 39 patients had a diagnosis at time of analysis; as had 13 in the second round: Initial compliance to the 28-day FDS was 33%, this increased to 85% in the second round. Median time to diagnosis was 36 days, decreasing to 12 in the second round (p-value <0.001). Median time to ultrasound was 28.5 days in the first round, decreasing to 9 in the second round (p-value <0.001). Conclusions Preliminary data shows a 53% improvement in compliance to the 28-day FDS, after introduction of the rapid-access clinic. This suggests the model could significantly improve compliance to national standards for diagnosing head and neck cancer presenting via neck lumps. This should encourage other tertiary head and neck services that creating rapid-access clinics can reduce delays in cancer diagnosis and treatment.

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