In Forth Valley, one of the strategies to help meet national cancer targets(1) is to bring patients referred with suspected colorectal cancer “direct to test” with colonoscopy or flexible sigmoidoscopy. To meet the demand on endoscopic services, such patients may have their diagnostic test performed by a colorectal surgeon, a nurse endoscopist, a gastroenterologist, or a non-colorectal surgeon. In Forth Valley approximately 60% of patients with colorectal cancer have their diagnostic test done by an endoscopist other than a colorectal surgeon. An unintended consequence of this has been the creation of two different pathways with patients not diagnosed by a colorectal surgeon waiting longer to meet their surgeon, hear later about staging results and waiting on average 17 days longer for surgery. Our aim was to eliminate these differences and make the pathway more person-centred.
