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Clinical and non-clinical team collaboration to develop breast referral triage to improve service delivery in secondary care

19 September 2024
Volume 33 · Issue 17

Abstract

Aims:

This evaluation combines clinical and non-clinical collaborative breast referral triage to gain an understanding relating to the value of triage, by identifying ‘suspected cancer’ and ‘cancer not suspected’ populations, improve the patient pathway, and facilitate optimised resource availability.

Method:

An iterative service improvement method was used, with distinct phases of the process outlined to facilitate testing of ideas. The evaluation ran for 13 weeks in 2022. Regular team member meetings were arranged to discuss and agree improvement aims and outcomes.

Findings:

A triage flowchart was developed collaboratively, and subsequently adopted by the non-clinical booking team. Bespoke clinics were established, demonstrating no evidence of increased risk to patients, and meeting 28-day Faster Diagnosis Standard (FDS) requirements.

Conclusion:

breast referral triage of ‘suspected cancer’ and ‘cancer not suspected’ patients, using a clinical and non-clinical collaborative approach facilitates improved service visibility, prioritisation, management, and measurement. This also supports delivery of the 2019 NHS Long Term Plan to enhance earlier and faster cancer diagnosis by optimising access to diagnostic resources where required.

Breast cancer is the most common cancer in the UK, affecting more than 55 000 people each year (Cancer Research UK, 2019). Sixty per cent of cancers are diagnosed following GP referral and 30% are diagnosed following surveillance in the NHS Breast Screening Programme (NHS England and Getting It Right First Time (GIRFT), 2021). Breast cancer incidence increases with age, with more than 25% of breast cancers diagnosed in people over 75 years of age, and fewer than 10% in those under 50 years of age (NHS England and GIRFT, 2021). In contrast, in the UK between 2018 and 2020, 2.5 breast cancers were identified per 100 000 women aged 29 years and under (National Cancer Registration and Analysis Service, 2022). This statistic generates a cancer conversion rate of 0.0025%, highlighting that those aged under 30 years are a low-risk population for developing breast cancer.

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