1. Andrew Low Respiratory Consultant BRI SWAG Lung SSG 15 November 2016
Two Week Wait Clinics
Andrew Low
Respiratory Consultant BRI
SWAG Lung SSG 15 November 2016

2. Aims 2WW wait challenges at the BRI The evolving service
Points for discussion
GP referral forms

3. 1997
“Things Can Only Get Better”
… suspected cancer… …prompt access to specialist services… …see a specialist within two weeks of their GP deciding…

4. 1997
2015
… suspected cancer… …prompt access to specialist services… …see a specialist within two weeks of their GP deciding…

5. Net Survival 2010-2011 – England & Wales

6. Lung cancer survival by Stage
IASLC Lung Cancer Staging Project 2007

7. Stage and Performance Status (2013-14) – RUH

10. Managing anxiety

11. Lung cancer 2 week wait referrals at the BRI

12. Lung cancer 2 week wait referrals at the BRI

13. 2WW Referrals at the RUH, Bath

14. Royal Devon and Exeter 2WW referrals
Diggins et al ERS Conference 2016

15. Patients diagnosed with lung cancer at BRI

16. 2WW referral outcomes

17. Inappropriate Referrals?
Diggins et al ERS Conference 2016

18. Origin of Lung Cancer Diagnoses

19. Origin of lung cancer patients
NCLA 2013

20. Non-emergency vs Emergency Survival
England – relative survival for lung cancer for non-emergency and emergency subgroups
Routes to Diagnosis: Exploring Emergency Presentations NCIN 2013

21. Week to week variability
Increasing patient clinics

23. Increased number of clinics? CT screening?
How to meet this demand?
Increased number of clinics?
CT screening?
Increasing anxiety

24. National “Optimal” Clinical Pathway
David Baldwin BTOG 2016

25. Points for discussion Managing increasing 2WW referrals
Is it a problem?
Is there a role for direct access to CT?
Should we be using CT to triage referrals?

26. Diggins, B, Anning L, Pope, S, Tapp, S, Patel, B
Diggins, B, Anning L, Pope, S, Tapp, S, Patel, B. A temporal increase in referrals to a two-week wait cancer clinic is not explained by an increase in inappropriate referrals. ERS Conference