Treatment and Pathways

The Cancer Alliance aims to reduce variation across Humber and North Yorkshire by supporting earlier and faster diagnosis of cancer, and improving equal access to treatment and care. By working collaboratively with its partners, the Alliance maintains a system-wide overview of cancer services and supports the implementation of a number of interventions that help improve performance, including:

  • Use of Faecal Immunochemical Tests (FIT) to guide the management of people with symptoms of colorectal cancer
  • Introduction of an image pathway for two week wait and suspected skin referrals
  • Achieving Faster Diagnostic Standards across all cancer pathways

Faecal Immunochemical Tests

Image shows a bowel cancer screening kit

The Faecal Immunochemical Test (FIT) is a type of faecal occult blood test used to detect traces of human blood in stool samples. FIT can be used:

as the primary test in the NHS Bowel Cancer Screening Programme (BCSP), aimed at individuals without symptoms.

as a test to guide the management of individuals who present with symptoms (symptomatic)

Since the start of the coronavirus pandemic, Humber and North Yorkshire Cancer Alliance has been working with its partners to accelerate the implementation of FIT into the two week wait referral process in order to safely manage waiting lists, improve patient experience and support faster access to treatment, when required.

Find out more about significant differences between each use of FIT here.

Clinical Delivery Groups

Each of Humber and North Yorkshire Cancer Alliance’s Clinical Delivery Groups (CDGs) provides an opportunity for clinical leaders to discuss best practice, share challenges, and reduce variation in practice.

The groups support the delivery of large scale transformational change across the system, by bringing together individuals from organisations and localities within our footprint, agreed programme workstreams, patients and the public, neighbouring cancer alliances, and other groups deemed appropriate by the chair to collaboratively develop new ways of working for the overall benefit of the population, particularly those affected by cancer.

CDGs are the source of expert clinical and professional opinion from which advice is sought on a wide range of cancer services issues. The groups adopt an evidence-based approach, incorporating national best-practice guidance, to ensure an improvement in common standards and pathways to uphold the Cancer Alliance vision of ‘achieving world-class cancer outcomes for our communities’.

Introducing Image Pathways for Skin Cancer Referrals

To support patients, manage NHS waiting lists safely and help cancer services recover from Covid-19, the Cancer Alliance has worked with relevant partners to support the use of images alongside urgent skin cancer referrals across Hull and the East Riding of Yorkshire.

Image shows a person holding an iphone which has a dematascope attached. The iphone is taking a picture of another personsarm.

Skin cancer is one of the most common cancers in HNY and the Alliance has provided 60 new iPhones and dermatoscopes to GP Practices across Hull and East Riding to help healthcare professionals rule out or diagnose skin cancer earlier, when treatment is often more successful.

In this video, Dr Dan Roper, Primary Care Lead for Humber and North Yorkshire Health and Care Partnership, explains how dermatoscopes are enabling specially trained GPs to capture and share microscopic images.

Radiotherapy Networks

Radiotherapy is the use of radiation to treat cancer. It destroys cancer cells in the area where it is given and can be used to try to cure cancer, reduce the chance of cancer coming back, or to help relieve symptoms.

In 2019, a Radiotherapy Network was established to bring together provider representatives from across Humber and North Yorkshire, South Yorkshire and Bassetlaw, and West Yorkshire and Harrogate to help reduce variation and improve cancer outcomes for patients. By working collaboratively, regional representatives are developing and maintaining up-to-date clinical guidelines and patient pathways, reviewing local data and metrics, and leading on rapid change.

Humber and North Yorkshire Cancer Alliance is a member of Operational Delivery Network (ODN), which governs the work of the Radiotherapy Network to ensure the delivery of its annual work programme. The aims of the Radiotherapy Network work programme are to:

  • Improve access to modern, advanced and innovative radiotherapy techniques, enabling more patients to benefit from cutting-edge technology and treatment
  • Improve the experience of care by ensuring that patients will be managed by an experienced multi-professional tumour specific subspecialist team able to provide holistic care
  • Increase participation in research and clinical trials in England, aiding faster development of new treatments and helping to drive the development of clinical services
  • Reduce variation in quality by adopting standardised best practice protocols, thereby improving patient outcomes
  • Reduce variation in equipment utilisation through changing operating arrangements, clinical practice and equipment replacement

You can read the specifications of the new services and more information about how NHS England is modernising radiotherapy services here.

Faster Diagnostic Standard (FDS)

The Alliance is supporting the implementation of a new Faster Diagnostic Standard (FDS). The FDS was introduced by NHS England and NHS Improvement to help facilitate a patient-centred flexible and rapid approach to cancer diagnosis/non diagnosis.

The FDS aims to ensure at least 75% (national standard) of patients who are referred for the investigation of suspected cancer find out, within 28 days, if they do or do not have a cancer diagnosis.

Clinically endorsed timed pathway guides are being used to implement FDS across all cancer pathways which will have the following benefits for patients, clinical and wider systems:

For patients:

Empowerment from information about the diagnostic process provided at point of referral
Reduced anxiety and uncertainty of a possible cancer diagnosis, with less time between referral and hearing the outcome of diagnostic tests
Improved patient experience from fewer visits to the hospital, particularly with ‘one stop’ services
Potential for improved survival by using the faster pathway to prevent patient deterioration

For clinicians:

Using a nationally agreed and clinically endorsed pathway to support quality improvement and reconfiguration of colorectal cancer diagnostic services
Working across primary and secondary care to ensure high quality referrals
Improved ability to meet increasing demand and ensure best utilisation of highly skilled workforce

For systems:

Reduce demand in outpatient clinics (ACE Wave 1 report highlights a 59% reduction in outpatient clinic appointments with implementation of straight to test)
Reduced medically unjustifiable delays in care.
Improved performance against national standards (particularly 62 day and 28-day standards)
Improved quality, safety, and effectiveness of care with reduced variation and improvement in outcomes