HNY Policy and Pathway Repository - York

From July 2021, chest x-ray no longer required as part of RDC referral work up.
Please refer to Gateway for additional referral criteria.

Suspicious symptoms in those >40 years

• Unexplained and unintentional weight loss (either documented >5% in 3 months or with strong clinical suspicion)
• Unexplained constitutional symptoms of 4 weeks or more (less if very significant concern). Symptoms include loss of appetite, fatigue, nausea, malaise, bloating
• Unexplained vague abdominal pain >4 weeks (less if very significant concern)
• Unexplained new or progressive pain, including bone pain, of four weeks or more
• GP ‘gut feeling’ of cancer diagnosis - reasons to be clearly described at referral

Does your patient meet the referral criteria for further investigation in Primary care?

Consider undertaking the first line tests in Primary care.

• Use the new Rapid Diagnostic Centre (RDC) button for selected tests on ICE. Ensure bloods are done within 48 hours of decision if possible. Bloods should be not older than 4 weeks and the FIT result not over 8 weeks old.
• Ensure you have discussed with the patient why you are doing these tests and how you are going to give these results to the patient e.g. face to face follow up or phone call (remember to have checked you have an up to date telephone number).

Results of first line investigations collated by primary care.

• Reassure patient and continue to follow up in Primary acre (“Watchful waiting”).
• Refer under existing 2WW pathway
• Refer on to the Serious Non Specific (vague) symptoms Rapid Diagnostic Centre pathway via 2WW form through RSS.

Referral on to the RDC pathway

• Complete all parts of the 2WW referral form for the RDC pathway and send through the RSS
• Please ensure patients contact details (address and telephone number) are correct.
• Please ensure availability of patient to attend for possible tests.

• Patient Leaflet
• Rapid Diagnostic Centre - process screenshots (now includes FIT Jan 2022)
• First six months audit summary