HNY Policy and Pathway Repository - North Yorkshire

If tests show non specific abnormality or normal please refer to Serious, Non- specific Symptoms Pathway using criteria & referral form.

None provided

Prior to referral the following investigations MUST have been undertaken in primary care:

• FBC
• U&E
• LFT
• Ca 125 (F)
• PSA (M)
• TFT
• HbA1c
• TTG (coeliac screen)
• Calcium/bone profile
• FIT
• Urine analysis to exclude haematuria, proteinuria
• Chest Xray

Referral Criteria

• >18. Well enough to attend clinic/Ambulatory investigations PLUS
• New unexplained and unintentional weight loss (either documented >5% in three months or strong clinical suspicion)
• New unexplained vague abdominal pain for four weeks or more (less if very significant concern) with no associated change in bowel habit
• New unexplained constitutional symptoms for four weeks or more (less if very significant concern) Symptoms include loss of appetite, fatigue, nausea, bloating or malaise.
• GP ‘gut feeling’ of cancer diagnosis 
• No diagnosis suggested by initial tests in Primary Care

Triage

• ANP/CNS to triage all referrals with current results
• RDS Coordinator to book ANP led clinic OPA for face to face consultation for clinical assessment

Clinic appointment

Based on clinical assessment decide on:

• 2nd line blood tests
• Further investigations as appropriate

MDT discussion – investigations/next steps:

• No evidence of cancer - discharge back to GP with advice letter
• Suspicion of cancer - upgrade onto a 62 day pathway
• Other disease - referral to other specialty as appropriate

• Harrogate and District