EP-609 Doctor-led Straight to Test Service: Streamlining the Colorectal 2ww referral pathway

Abstract

Abstract Aims Since its introduction in 2000, the Two-week wait referral pathway (2ww) has become entrenched in NHS practice to fast-track the investigation, diagnosis and management of suspected cancer. Straight-to-test (STT) routes further expedite this process: staff screen referrals and offer a diagnostic test within 2 weeks where appropriate. Our Trust has provided a doctor-led STT service for the Colorectal Department since January 2021. We hypothesize that physician-led strict scrutiny of referral proformas, with incomplete forms being returned to GPs, has led to improved compliance with the referral process. Methods A prospectively maintained database consisting of 2ww Colorectal referrals from primary care was analysed over a 12-month period (January 2021- December 2021). Agreed key referral criteria required to make an STT decision were identified as ‘complete’ or ‘incomplete’. Incomplete referrals were returned to GPs, with a request for complete information (usually provided within a median period of 2 weeks). Results There were 1112 referrals during January-April 2021, 1140 during May-August 2021 and 1158 during September-December 2021. The proportion of referrals containing incomplete datasets fell from 28% (January-April 2021) to 17% in the latter two 4-monthly time intervals. Conclusions Our data is promising- the proportion of incomplete referrals has reduced since the introduction of our doctor-led STT triage service. These figures may reflect a positive change in the referral practises of local GPs. Submission of complete referral forms improves communication between primary and secondary care, enabling our doctors to make timely informed decisions about STT pathways.