Lung cancer pathway
We know that this is an especially worrying time so we have created a key messages document for Health Professionals focussed on safety netting patients presenting with symptoms during the coronavirus outbreak. We have also created a page on the subject specifically for patients on our about cancer hub. We will update that information as guidance changes.
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Currently, the ACE Programme is focused on reducing unwarranted variation in access to diagnostics and treatment, for patients diagnosed with lung cancer. The National Lung Cancer Audit (for the period 2017) reports that, 'one in five patients with potentially curable disease do not receive optimal treatment'. We are exploring factors that are driving these unwarranted variations, from why some patients may choose not to undergo surgery to biases in the design of local health systems.
Using a case-study approach, ACE is developing good practice approaches that help resolve some of these root causes of variation. The focus is on ensuring consistent diagnostic and treatment options are being offered to patients who present with similar profiles.
We will publish the case studies when we have our findings.
Case Study 1
Highlight the positive impact of a structured patient ‘first-touch’ protocol, particularly in the uptake of optimum treatment
Case Study 2
Explore pathway arrangements that help increase the active treatment options offered to complex patients often regarded borderline fit for radical therapies, on the grounds of age, fitness, stage etc.
Case Study 3
Describe how the sequencing of diagnostic tests into bundles can accelerate the timeliness in confirming a cancer diagnosis, determining more treatment options.
Case Study 4
Explore how ‘networked’ solutions to constrained diagnostic services can help solve individual trust capacity and workforce issues.
We want to hear from you! Please complete our quick survey telling us which case study sounds most useful. And if there are any new case studies you would be particularly interested in.
Our previous ACE Wave 1 projects explored various ways of streamlining lung cancer pathways. The below reports provide practical information on ways to achieve 'better practice' and includes a set of clear recommendations.
The aim of this project is to assess potential delay points in lung cancer patients receiving their diagnosis, using linked national datasets, to provide a large scale understanding of common pathways and interval timings.
During Wave 1 of the Programme several projects were piloted along the lung cancer pathway. Here you can find documents relating to the projects.
A14 Horsham and Mid-Sussex
The project will develop a new pathway for cancer patients going to Brighton and Sussex University Teaching Hospitals (BSUH), which will involve straight to CT following an abnormal Chest X-Ray.
A16 Nottingham City
Through direct access to CT by GPs, when locally agreed criteria have been met, the project aims to improve 2WW pathway flow and appropriateness of straight to test and one stop clinics referrals.
The projects will complete an audit to review and establish key reasons for delay in presentation with lung cancer as well as develop and implement an integrated and streamlined lung pathway.
A71 Manchester Cancer and The Christie NHS Foundation Trust
The project will perform a data analysis to drive improvement of sectorised model of care, measurement and performance management and define quality standards of lung cancer pathways in Manchester.
A77 North Staffordshire University Hospital
To introduce a system by which abnormal Chest X-Ray automatically triggers a CT scan request by radiologist, GP informed and eGFR requested – to reduce the anxiety of non-cancer patients and improve diagnostic investigation time for cancer patients.
By developing a straight to CT following an abnormal Chest X-Ray pathway, the project has many aims including; promoting joined-up working between primary and secondary care and improving lung cancer survival rates through earlier detection.
Can’t quite find what you are looking for?
Please see the list of documents available upon request
This cluster of wave 1 projects considers which proactive approach provides the most cost-effective method of finding undiagnosed early stage lung cancer; one project explores self-referral to chest x-ray.
Evaluation of a health service adopting proactive approach to reduce high risk of lung cancer: The Liverpool Healthy Lung Programme - This document is available upon request here
A33 Manchester, Lancashire and South Cumbria
The project aims to achieve a step change improvement in earlier diagnosis by utilising a risk-stratification process to identify people at highest risk of lung cancer; and then offering them a low dose CT scan as well as targeted smoking cessation advice and support.
The project will raise awareness of respiratory health and illness in communities with high incidence of lung disease and lung cancer. Members of the project will also work with GP practices to risk assess people, and offer low dose CT to those who meet agreed criteria.
Liverpool - Breathe freely leaflet
Liverpool - Lung health clinic CT scan FAQs leaflet
Liverpool - Lung health clinic nodules information leaflet
Liverpool - lung health clinic referred for a CT scan FAQs leaflet
Liverpool - Patients not referred for CT healthy lung
A64 Mid Cheshire
The project is focusing on health prevention and promotion of healthy lungs as well as the introduction of a self-request Chest X-Ray service targeted at populations where incidence and mortality is high.
Service evaluation report
A90 London, University College London (UCL)
UCL’s Health Behaviour Research Centre and Lung’s for Living Research Centre will pilot a lung screen uptake trial across UCLH and Homerton.
A91 Nottingham CCG
This project forms The Rebalancing Foundation which will support vulnerable populations access specialist care to improve lung health in North Nottingham. Areas covered includes lung disease, lung cancer and stop smoking services.
Nottingham - CT information form for lung health checks
Nottingham - Lung health check leaflet