Evaluation of Primary care access to CT scans for patients suspected Lung Cancer with normal chest x-ray

Abstract

Background: NHS England due to implement National Optimal Lung Cancer Pathway, where cancer diagnosis by day 28. Currently GPs don9t have direct access to CT sacns and have low thresh hold to refer patients to Fast Track(FT) clinics.This resulting in considerable delay for appointments and diagnostic tests. Aims and Objectives: To prove that GPs with direct access to CT will streamline the patient pathway,patients being referred to most appropriate clinical setting, reducing demand and delay for FT clinics. Methodology: Pilot period between May 2018-November2018,supported by Blackpool and Fylde&Wyre Clinical Commissioning Groups.GP direct access CT proforma was produced with input from Trust9s Radiology Department. Strict referral criteria allowing radiologist to retain controll of the process to avoid unnecessary tests.Referral proforma uploaded to GP9s EMIS portal for easy access.Funding secured from Cancer Alliance.Database managed by cancer services witch captured demographics, symptoms,CT date&reporting,FT referral and outcome. Results: 130 CT requests were received.Average patients age was 68 years. 70% current or ex smokers. Average turnaround time for CT was 5.5 days for 80% patients.38% required FT clinic referral. 14 new cancers were diagnosed. 34% reduction in 2WW referral compared to corresponding period in 2017 (342 referral in 2017 Vs 259 in 2018).Average cancer pick up rate for the pilot phase was 45.7% compared with 28% for the corresponding period in 2017. Conclusions: Primary care direct access to CT scans prior to cancer FT clinic resulting in more meaningful first appointment, reduction in demand and waiting for FT clinic appointments.