HNY Policy and Pathway Repository - Humber

This pathway exists for patients who are considered to have vague, non-specific, symptoms. Provided minimum referral criteria is met patients will receive chest x-ray and abdominopelvic ultrasound as a minimum. 

Any patient with specific alarm symptoms warranting referral onto site-specific two week wait pathway should NOT be referred along the RDS pathway (in line with NG12). With the exception that patients who test FIT positive can be referred to RDS if there are additional vague symptoms present. 

DO NOT REFER

• Patient has specific alarm symptoms warranting referral onto site-specific two week wait pathway (in line with NG12)
• Patient is too unwell or unable to attend as an outpatient or needs acute admission
• Patient is likely to have a non-cancer diagnosis suitable for another specialist pathway
• Patient is currently being investigated for the same problem by another specialist team

It is recommended the following filter function tests are carried out in primary care, where relevant for patients, to make a successful referral into RDS.

Core tests for patients with non-specific symptoms:

• Urine dip for haematuria
• FIT test (This is hugely important to avoid duplication of tests as if >10 will need colorectal 2ww referral and either CT virtual or optical colonoscopy. Abdominal CT in the community is therefore not required and will be a wasted appointment.
• FBC, CRP, U&Es, LFTs, TFTs, HBA1c, CA-19.9

CA-125 and PSA if appropriate.

Referral Criteria

• Minimum age of referral is 18.
• Unexplained and unintentional weight loss (either documented >5% in three months or with strong clinical suspicion)
• Unexplained constitutional symptoms of four weeks or more (less if very significant concern). Symptoms include loss of appetite, fatigue, nausea, malaise, bloating (to be specified on the referral).
• Unexplained vague abdominal pain of four weeks or more (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

Referrals

The service can be accessed via the Electronic Referral Service (ERS) under RWA for HUTH services. The full Directory of Services (DOS), core filter test requirements and the correct referral form are all available. Patients will be seen within 14 days and a report issued by day 28 of referral. Further advice and guidance concerning referrals please email hyp.tr@HEYRadiologyEnquiries@nhs.net

Referral form on ARDENS

Information for patients can be found:

Rapid Diagnostic Service | Hull University Teaching Hospitals NHS Trust

Information to include

Indicate one or more of the RDS indications in the “current clinical details box” and include specifics where prompted.

Indicate the FIT status ([FIT score], [Not done], or [Awaiting result])

Please provide a Rockwood frailty score for patients >65years

Name, Designation and GMC / NMC or HCPC Reg No. of referrer.