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We are particularly pleased to see the plan to roll-out Rapid Diagnostic Centres (RDCs) across the country following the 2018 trial. Cancer alliances are required to have at least one RDC site accepting patients NLT January 2020. The aim with RDCs is that ‘patients displaying symptoms of cancer can be assessed and diagnosed in as little as a day.’
Existing suspected cancer referral pathways focus on suspicion of tumour-specific disease rather than on diagnosing symptoms. There is currently no dedicated urgent diagnostic pathway for patients who present – often repeatedly – with vague, non specific, symptoms as CUP patients often do. Consequently, a patient may, to quote the NHS’s Rapid Diagnostic Centre Vision and 2019/20 Specification see their GP multiple times before referral; present more often in an emergency setting; present with late stage cancer (analysis of the National Cancer Diagnosis Audit shows 67% of people with non-specific symptoms are diagnosed at a late stage in comparison to 45% for people with site-specific symptoms); are referred on multiple urgent pathways with resulting inefficiencies in healthcare provision.
It is encouraging that the spec for referral to an RDC includes a GP’s ‘gut feeling’ about cancer as well as symptoms such as unexplained weight loss, fatigue, abdominal pain or nausea.