More than one in ten patients seen by new cancer diagnostic services have been referred for cancer treatment, helping to speed up treatment and improve outcomes. Patients waited an average of 14 days from referral, to having cancer ruled in or out.
An evaluation report into Scotland’s first Rapid Cancer Diagnostic Services (RCDS), published by the University of Strathclyde and the Centre for Sustainable Delivery (CfSD), found 11.9% of patients seen over the two year period were diagnosed with cancer. Around 6% were given a pre-cancer diagnosis, meaning they require further monitoring in case a cancer develops, and the remainder were either given the all clear and referred back to primary care or diagnosed with other non-cancer conditions (41.1% and 40.7% respectively).
The Rapid Cancer Diagnostic Services, currently in place across five Health Board areas, were established to help speed up cancer diagnoses for patients with non-specific symptoms such as unexplained weight loss, persistent nausea or fatigue, where the GP has a concern of a malignancy. Over the two-year evaluation period the services saw 2,489 patients, with more than 96% of them giving the service a positive satisfaction rating of eight out of 10 or more.
The report highlighted that the model delivers a quality service at speed, is cost effective compared to previous pathways, and highly valued by patients and staff. Positive patient experience is attributed to the speed of referral, reduction in waiting times for diagnostic tests, having a single point of contact and enhanced information and communication throughout the RCDS pathway.
Care at speed
Professor Robert van der Meer, Co-Lead Author of the RCDS Evaluation, University of Strathclyde: "Scotland’s Rapid Cancer Diagnostic Services (RCDS) are working well. They’re achieving what they set out to do – find cancer – while delivering a high standard of quality care at speed. RCDS patients are complex and the specialist input that the RCDS can offer them, and concerned primary care clinicians, marks a gear-change in how we diagnose cancer in Scotland. RCDSs should be used as an exemplar for cancer care with learning embedded across all pathways.”
Visiting NHS Lanarkshire’s RCDS at University Hospital Wishaw, Health Secretary Neil Gray said: "Improving cancer services is a priority for the Scottish Government, as set out in our 10-year strategy published last year. This positive evaluation of Scotland's Rapid Cancer Diagnostic Service provides valuable insight into their role in achieving vital earlier cancer diagnoses and improving patient care.
RCDSs reflect our commitment to enhancing equitable cancer services across NHS Scotland - this report has shown the pivotal role they can play in early cancer detection while delivering quality patient-centred care. As Scotland's cancer care continues to evolve, RCDSs stand as an essential component in improving outcomes.
Mr Martin Downey, NHS Lanarkshire Rapid Cancer Diagnostic Service Clinical Lead and Associate Medical Director for Access, said: “The Rapid Cancer Diagnostic Service offers a timely, often one-stop, environment for clinically complex patients with potentially serious non-specific symptoms suspicious of cancer, such as weight loss, fatigue, nausea and abdominal pain.
“These patients typically did not meet the criteria for existing cancer pathways and the service makes a positive difference to these patients, providing rapid patient centred assessment, diagnosis and coordination of ongoing care.”
Accurate diagnosis
There are currently five RCDS live in NHS Scotland – NHS Ayrshire & Arran, NHS Dumfries & Galloway, NHS Fife, NHS Borders and NHS Lanarkshire.
RCDS, modelled on the Danish Rapid Diagnostic Centres, has transformed cancer diagnostic pathways in NHS Scotland. These centres, built within existing NHS Scotland infrastructure, provide expedited diagnostic services to patients with non-specific symptoms suspicious of cancer, aiming for timely and accurate diagnosis in a streamlined process.
Prior to Scotland’s two-year pilot, patients that did not meet the Scottish Referral Guidelines for Suspected Cancer, or who presented with non-specific suspicious symptoms, would have to have a series of tests coordinated by primary care.
Over a two-year period, RCDS received 3,616 referrals, with 2,489 (approximately 69%) accepted into the programme. The mean time to vetting was 1.5 days.
Scottish Government policy in recent years, including the NHS Recovery Plan, published August 2021, Cancer Recovery Plan – Recovery & Redesign: An Action Plan for Cancer Services, published 2020, and most recently the Cancer Strategy for Scotland (2023-2033), published June 2023, commit to growing Scotland’s network of RCDS.