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This repository is designed to be a comprehensive directory of best practice, easily accessible to Cancer Teams across NHS Scotland, to aid shared learning and support redesign efforts.

Available resources for different cancer types will expand and evolve over time, with an initial focus on Scotland’s earlier diagnosis priorities – lung, head and neck and colorectal cancer.   As reflected in the Cancer Strategy and Action Plan for Scotland, an ambition has been set to reduce later stage disease (stages 3 & 4) by 18% over the next 10 years, of which redesigning cancer diagnostic services will play a part in delivering.

The Scottish Cancer Network's  'Once for Scotland' Cancer Clinical Management Pathways which outline the patient journey from diagnosis through to follow-up or end of life care, can be found on the Right Decision Service.

Below you will be able to access toolkits, developed with Scotland’s Regional Cancer Clinical Leads, to support implementation of these pathways that include several examples of best practice already being embedded.

In the key resources section below you will also be able to access the latest versions of the Scottish Referral Guidelines for Suspected Cancer, Framework for Effective Cancer Management, NHS Scotland’s Cancer Waiting Times Data & Definitions Manual as well as the recently developed ‘Once for Scotland’ guidance, including regrading of urgent suspicion of cancer (USC) referrals.

Lung Cancer
Head and Neck Cancer
Key Resources

Framework for Effective Cancer Management: A refresh of the Framework was published Friday 3 December 2021, providing NHS Cancer Teams with the tools to effectively manage patients from the point of referral to first treatment, in order to improve patient experience as well as cancer waiting times performance.

In line with the Framework, detailed recommendations and action plans have been developed in partnership with every territorial Health Board in Scotland, to ensure the Framework is fully embedded and that urgent suspicion of cancer (USC) patients move timeously through their pathway, with any backlogs that have emerged as a result of the pandemic cleared.

 

Cancer Waiting Times Data & Definitions Manual, Version 5.4There are currently two cancer waiting times standards in Scotland:

62 day: from urgent referral with suspicion of cancer, including referrals from national

cancer screening programmes, until first treatment.

31 day: from decision to treat until first treatment, regardless of the route of referral

There is currently a 5% tolerance on each standard in Scotland.

This document aims to cover all the necessary definitions for implementing the cancer waiting times standards; however, if you have any further questions please contact phs.cancerwaitsnew@phs.scot

 

Effective Breach Analysis Standard Operating Procedure (SOP): A ‘One for Scotland’ approach to Effective Breach Analysis SOP has been developed with the following purpose:

  • Prevention of avoidable breaches of the 31-day & 62-day cancer waiting times standards;
  • Learning and validation when breach occurs;
  • Link effective communication and governance of breaches to cancer waiting times performance;
  • Prevention by pathway adaptation.

 

Scottish Referral Guidelines for Suspected Cancer: The aim of these guidelines is to facilitate appropriate referral between primary and secondary care for patients whom a GP suspects may have cancer. The guidelines are intended to help GPs, the wider primary care team, other clinicians and patients and carers to identify patients who are most likely to have cancer and who therefore require urgent assessment by a specialist.

Equally it is hoped that the guidelines will help GPs to identify patients who are unlikely to have cancer and who may appropriately be observed in a primary care setting or who may require non-urgent referral to a hospital.

 

Urgent Suspicion of Cancer (USC) Regrading Guidance: Regrading of Urgent Suspicion of Cancer (USC) referrals at the point of clinical vetting is currently utilised widely, but variably, across NHS Scotland. Regrading of referrals using objective criteria from the Scottish Referral Guidelines for Suspected Cancer, is of utmost importance for ensuring that the right person is on the right pathway at the right time.

A supporting toolkit of best practice examples has been developed to aid Health Boards to utilise the Regrading Framework within their existing pathways.