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The NHS have released a progress check against the NHS Long Term Plan commitments for cancer. There are two targets of particular interest to us: (1) the roll-out of RDCs and (2) genomic testing for patients who are newly diagnosed with cancer.
Roll-out of Rapid Diagnostic Centres
In 2019 every Cancer Alliance set up its first RDC pathway, based on a new pathway for people with symptoms that are serious but not
specific (non site specific RDC), and submitted a plan for full rollout of RDCs to all cancer pathways by 2023/24. The pandemic has caused some disruption for RDC implementation. However, in 2021/22, the intention is for Cancer Alliances to reach 50% population coverage for the non-site specific RDCs. Alliances are also focusing on implementing specific symptom pathways for tumour sites where the treatment gap is largest.
83 RDC pathways are now live, two thirds of which are for nonspecific symptoms. There were more than 3,000 referrals to RDCs in March 2021, over 1,500 of which were for non-symptom-specific pathways. Along with non-specific symptoms pathways, we are focused on the most challenged two-week wait pathways, to help diagnose patients more quickly and accurately. From May 2020 to March 2021, RDCs diagnosed 795 cancers.
The use of molecular diagnostics
From 2020/21, the target has been to begin to offer more extensive genomic testing to patients who are newly diagnosed with cancers so that by 2023 over 100,000 people a year can access these tests. The seven NHS Genomic Laboratory Hubs (GLHs) have begun to implement more extensive genomic testing for patients in their geographies, including large pan-solid tumour panels. The National Genomic Test Directory (Test Directory) sets out the range of testing that is commissioned by the NHS in England. The current review of applications for updating the Test Directory for 2021/22 will be implemented from summer 2021.