2 week wait colorectal referrals – impact on hospital services
Fady Hatem, Amber Davies, Annabel Hentall Maccuish, Vivekanandan Shanmugam, Vijay Vardhini, Srinivasaiah Narasimhaiah
Aim: Fast track colo-rectal referrals brought an enormous stress on the resources. Its intended benefits include early detection of colorectal cancer, treatment in early stage, improved morbidity and mortality. We aim to assess the efficacy of the Cancer waiting time(CWT) referral system within our Trust and its impact on the services.
Methods: retrospective study from April 2015–April 2017. All Colo-rectal cancer fast track referrals received over 24months were audited. Yearly data is presented and compared to national cancer pick up rate.
Between April 2015-2016, 1550 CWT referrals were received. 81(5.2%) cases of colorectal cancers were diagnosed. In the subsequent year, 1891 referrals were seen. 87(4.6%) cases of colorectal cancers were diagnosed.
Male to female ratio was equal.
(51%) above 70years.
Of the referrals, (1800) 96.6% had specialist review within 14days.
Endoscopy was the first investigation of choice in (57%) of patients, whose average age was 68yrs.
In the higher age group(Average 76 yrs), a CTscan was performed first in (25%)patients.
Most referrals only underwent one investigation (67%).
Among CRC patients, (74patients) 85% received treatment within 62days and 43patients (50%) underwent surgical intervention as a first treatment.
There is a steady increase of volume of colorectal CWT referrals received by our Trust. This could be a reflection of increased awareness and geographical catchments.
Our pickup rate is well above the national average. Targets are met, despite the increasing workload. This will have implications on the service providers and policy makers. Increasing awareness and streamlining of GP referrals will improve the quality of referrals, thereby translating to better efficacy.