P001 DELAY IN LUNG CANCER CLINIC APPOINTMENT: AUDIT OF GP REFERRALS

N. Surange, F. Zaman.Burnley General Hospital, UK

The NICE (National Institute for Health and Clinical Excellence) guidelines for the diagnosis and treatment of lung cancer¹ advise that patients with a chest x ray (CXR) suggestive of lung cancer should be referred urgently to a respiratory physician (1.1.5). They advise that a copy of the CXR report be sent to the lung cancer multidisciplinary team (MDT) for an appropriate action (1.2.1). The referral pathways of these patients differ between hospitals. In Burnley the report of an abnormal CXR is sent to the patient’s GP who then refers the patient to the fast-track lung cancer clinic.

We audited retrospectively the GP referral letters marked “2 week rule” in 2005 (n = 80) and the patients’ case notes with an aim of assessing the potential delay in the lung cancer clinic appointment caused by the practice of receiving referrals from GPs. We did this by calculating the number of days between (1) date of first CXR and date of GP referral to the lung cancer clinic; (2) date of GP referral and date of first appointment for the two week lung cancer clinic.

Discussion: In Burnley General Hospital the outpatient CXRs are reported on the same day and the report faxed to the GP by the next working day. The lung cancer specialist nurse receives a copy of the CXR report and reminds the GP if a referral is not received within the next 7 days, but the MDT does not intervene in any other way. Our audit showed that there was a median delay of 10 days from the date of chest x ray (that is, 9 days from receiving CXR report) to the date of sending a referral to lung cancer clinic.

Conclusion: This audit reveals that direct action by the …