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Published byTreyton Haines Modified over 10 years ago
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62 day performance John Wayman North Cumbria
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62 Day performance 2012 (Upper GI)
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Upper GI Cancer pathway Triage of referral EndoscopyHistologyCTLocal MDTSpecialist MDT Further Investigation Neo-adjuvant chemotherapy
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Upper GI Cancer pathway Triage of referral EndoscopyHistologyCTLocal MDTSpecialist MDT Further Investigation Neo-adjuvant chemotherapy 14 days
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Upper GI Cancer pathway Triage of referral EndoscopyHistologyCTLocal MDTSpecialist MDT Further Investigation Neo-adjuvant chemotherapy 14 days
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Upper GI Cancer pathway Triage of referral EndoscopyHistologyCTLocal MDTSpecialist MDT Further Investigation Neo-adjuvant chemotherapy 14 days
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Upper GI Cancer pathway Triage of referral EndoscopyHistologyCTLocal MDTSpecialist MDT Further Investigation Neo-adjuvant chemotherapy 14 days 7 days
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Upper GI Cancer pathway Triage of referral EndoscopyHistologyCTSpecialist MDT Further Investigation Neo-adjuvant chemotherapy 14 days 7 days
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Upper GI Cancer pathway Triage of referral EndoscopyHistologyCTSpecialist MDT Further Investigation Neo-adjuvant chemotherapy 14 days 7 days
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Upper GI Cancer pathway Triage of referral EndoscopyHistologyCTSpecialist MDT Further Investigation Neo-adjuvant chemotherapy 14 days 7 days
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“Further Investigations” EUS (Newcastle)MDT PET CT (Preston)MDT Neck USS (NCUH)MDT CPEX fitness assessment (Newcastle) MDT Laparoscopy (Newcastle/NCUH) MDT
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“Further Investigations” EUS (Newcastle)MDT PET CT (Preston)MDT Neck USS (NCUH)MDT CPEX fitness assessment (Newcastle) MDT Laparoscopy (Newcastle/NCUH) MDT <20days?
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Why are we missing 62 day target? Nationally Long, multi-step pathway Diminishing performance of steps: “Step”“Pathway” 195%95% 295%90% 395%85% 495%80% Locally Limited capacity – CT – USS – MRI – Bronchoscopy – Endoscopy Reliance on other providers – EUS – C-PEX – PET CT – EMR
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Saving time Solutions – >95% OGD within 7 days – >95% CT within 7 days – Investigate in parallel – Provide EUS and PET in house – Staging Admission – Remove MDT re-visits from pathway (Investigated to Protocol) Risks – Capacity? – Over investigation – Cost of equipment and expertise – Capacity? – Exclude specialist interpretation of results and insufficient CNS support to co-ordinate
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Suggestions? Agree protocols for local MDT’s for – PET/Bone scan – EUS – Neck USS – Bronchoscopy – C-PEX Discuss at specialist MDT only after all investigation complete (or a result which “stops” the curative pathway) Combine investigations – EUS + Neck USS + C-PEX/Anaesthetic assessment Other Suggestion??
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