National Optimal Lung Cancer Pathway Research Articles

A two-cycle audit of the radiology components of the National Optimal Lung Cancer Pathway at St George’s Hospital

A two-cycle audit of the radiology components of the National Optimal Lung Cancer Pathway at St George’s Hospital

Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial

The National Optimal Lung Cancer Pathway recommends rapid progression from abnormal chest X-rays (CXRs) to CT. The impact of the more rapid reporting on the whole pathway is unknown. The...

EP01.06-002 Impact of Immediate AI Enabled Patient Triage to Chest CT on the Lung Cancer Pathway: LungIMPACT

In England, 30% of patients die within 90 days of diagnosis and late diagnosis is strongly implicated in comparatively poor survival shown by the International Cancer Benchmarking Partnership. UK guidance recommends the chest radiograph (CXR) for initial investigation of certain red-flag symptoms but CXRs are done for many indications and may pick up lung cancer as an incidental finding. Thus, the National Optimal Lung Cancer Pathway (NOLCP) was developed to address, amongst other issues, a rapid process from progress from abnormal CXR to CT and clinic.

95 - Incidence and outcomes of malignant disease, other than lung cancer, diagnosed via the direct to chest CT pathway (DtCCTP) of the National Optimal Lung Cancer Pathway (NOLCP)

95 - Incidence and outcomes of malignant disease, other than lung cancer, diagnosed via the direct to chest CT pathway (DtCCTP) of the National Optimal Lung Cancer Pathway (NOLCP)

P28.03 An Autoethnographic Study Exploring the Role of the Lung Cancer Nurse Specialist in the National Optimal Lung Cancer Pathway

Background: The National Optimal Lung Cancer Pathway (NOLCP) is a pathway hospitals in the UK are expected to follow which advocates a standardised care pathway. The pathway is aimed at improving lung cancer care to enable time to treatment within 49 days. The Lung Cancer Nurse Specialist is a core member of the Multidisciplinary Team providing expert knowledge, specialist assessment and advanced communication. They also act as an advocate for patients on the NOLCP. The aim of study was to explore the role of Lung Cancer Nurse Specialist in the NOLCP and the Lung Cancer Specialist Nurse's experience of the “meet the Lung CNS “ aspect of the NOLCP. An autoethnographic study of 16 practicing Lung Cancer Nurse Specialist’s from different centres across the country who reflected on the first meeting with two patients on the NOLCP. Written reflections were subjected to thematic analysis and Gibbs reflective model was used to complete the reflections. Four key themes were identified: 1. Co-ordination of complex care. This is delivering care in accordance with the NOLCP, avoiding delays and ensuring right care, right time in the right place. 2. Relationship building and advanced communication. Utilising specialised knowledge along woth advanced listening and communication skills. Being accessible and providing accurate information and advice 3. Specialist patient assessment and management. This involves the undertaking of specialist holistic assessments to support the treatment and management of lung cancer and its symptoms. 4. Support and management of emotions and expectations. Providing emotional support and management of unrealistic expectations for patients and relatives, as well as themselves and the wider healthcare community These four themes were underpinned by a fifth cross-cutting theme which was effective utilisation of resources. Lung Cancer Nurse Specilaists are pivotal in the delivery of high quality lung cancer care. Through the provision of specialist and expert nursing care, Lung Cancer Nurse Specialists co-ordinate complex care, undertake holistic patient assessment and support and management expectations. This is achieved through successful relationship building and advanced communication skills and appropriate and effective utilisation of resources. Recommendations Clarification of the Lung Cancer Nurse Specialist role is required both locally & nationally. Implementation of the NOLCP will add increased demand on Lung Cancer Nurse Specialist services which are already under-resourced. Adequate provision must be made to meet this requirement.

54 - The impact of anticoagulation and antiplatelet drugs on the National Optimal Lung Cancer Pathway

54 - The impact of anticoagulation and antiplatelet drugs on the National Optimal Lung Cancer Pathway

177 - Introduction of Lung Cancer Patient Navigator at North Middlesex University Hospital (NMUH): how does it influence performance in meeting National Optimal Lung Cancer Pathway Times?

177 - Introduction of Lung Cancer Patient Navigator at North Middlesex University Hospital (NMUH): how does it influence performance in meeting National Optimal Lung Cancer Pathway Times?

172 - An autoethnographic study to explore “meet the Lung CNS” as stated within The National Optimal Lung Cancer Pathway (NOLCP) guidance: recommendations for best practice

172 - An autoethnographic study to explore “meet the Lung CNS” as stated within The National Optimal Lung Cancer Pathway (NOLCP) guidance: recommendations for best practice

Improving Lung Cancer Pathway - The Significance of Marginal Gains

Background: The National Optimal Lung Cancer Pathway (NOLCP) guidelines was published recently. The aim of NOLCP is to encourage local services to review their pathways.

P1.07-11 An Evaluation of the Patient’s Experience and Expectations During the Implementation of NHS England, National Optimal Lung Cancer Pathway

P1.07-11 An Evaluation of the Patient’s Experience and Expectations During the Implementation of NHS England, National Optimal Lung Cancer Pathway

National Optimal Lung Cancer Pathway implementation: can pathologists comply with turnaround times?

National Optimal Lung Cancer Pathway implementation: can pathologists comply with turnaround times?

Implementation of National Optimal Lung Cancer Pathway: an early experience

Implementation of National Optimal Lung Cancer Pathway: an early experience

National Optimal Lung Cancer Pathway: implementation of a ‘straight to CT’ pathway at NUH

National Optimal Lung Cancer Pathway: implementation of a ‘straight to CT’ pathway at NUH

Implementation of the National Optimal Lung Cancer Pathway: the Nottingham experience

Implementation of the National Optimal Lung Cancer Pathway: the Nottingham experience

Achieving the National Optimal Lung Cancer Pathway: the role of the biomedical scientist

Achieving the National Optimal Lung Cancer Pathway: the role of the biomedical scientist

Triage of suspected cancer referrals as part of the National Optimal Lung Cancer Pathway (NOLCP): is this acceptable to patients?

Triage of suspected cancer referrals as part of the National Optimal Lung Cancer Pathway (NOLCP): is this acceptable to patients?

Early experience from the Plymouth National Optimal Lung Cancer Pathway

Early experience from the Plymouth National Optimal Lung Cancer Pathway

Understanding current lung cancer service to drive improvements towards achieving the national optimal lung cancer pathway at a busy district general hospital

Understanding current lung cancer service to drive improvements towards achieving the national optimal lung cancer pathway at a busy district general hospital

One size doesn’t fit all. Arguments for and against pathway redesign in a small District General Hospital (DGH) to accommodate the National Optimal Lung Cancer Pathway

One size doesn’t fit all. Arguments for and against pathway redesign in a small District General Hospital (DGH) to accommodate the National Optimal Lung Cancer Pathway

P3.11-18 Implementing One Stop Lung Clinic to Improve Diagnostic Timeliness in Lung Cancer Patients in the North of England

Employing just one modification (early use of endobronchial ultrasound) has been shown to improve survival in a randomised controlled trial (Navani et al. Lancet Respir Med 2015). A new innovation set out to implement One Stop lung clinic to reduce diagnostic times as a part of of the Macmillan Integrated Cancer Care Programme on the Lung Cancer Pathway maping started in 2014, which pre-dates the National Optimal Lung Cancer Pathway. Aim of the study was to demonstrate shorter time to diagnosis for patients with suspected lung cancer referred from general practice on a '2 week wait' referral pathway in the UK. Data relating to diagnostic intervals of the patient’s attending One Stop clinic collected and interim analysis performed. The diagnostic intervals were analysed using descriptive analysis to establish the timeliness of intervals from first seen to diagnosis and discussion at the Multi-Disciplinary Team (MDT) meeting. 33 patients attended One Stop clinic and received a CT and then either bronchoscopy, endobronchial ultrasound or pleural aspiration on the same day. 48% (n=15) of patients were diagnosed with a primary lung cancer, 16% (n=5) - with other malignancies including myeloma, lymphoma and colorectal cancer and 32% (n=10) - with non-malignant conditions. The diagnostic intervals from first seen in a lung clinic to diagnosis were in range between 9 and 37days. 39% (n=13) of patients attending the clinic were worked up for the lung MDT discussion within 9 days, 24% (n=8) of patients - within 16 days, 6% (n=2) of patients - within 23 days. In 9% (n=3) of the cases the work up took 30 days or over. 15% (n= 5) were taken off the pathway and 6% (n=2) - were referred for best supportive care. Diagnostic intervals for a cohort of patients attending the clinic were shorter in comparison to England’s National Cancer Standard of 31 days from referral to diagnosis. It is argued that One Stop clinic which involves a CT, then either a bronchoscopy, endobronchial ultrasound or pleural aspiration completed all on the same day reduces the time to diagnosis and improves organisational performance. Interventions for expediting earlier diagnosis of lung cancer need to focus on the compliance of diagnostic services to be all aligned in a rapid one stop environment to improve the earlier diagnosis of lung cancer.