North London Cancer Network

These screening referrals are not covered by the 2ww standard and there is no national target for time to first seen for these patients so this portion of the pathway will not be monitored as a standard centrally.

However, there are internal QA waits standards within the screening programme and if these internal standards are met, the vast majority of patients diagnosed with cancer via the screening programmes will be able to receive their first treatment within 62 days of receipt of referral if they were clinically fit and wanted to be treated within this timescale.

For direct referrals, day 0 is receipt of referral (i.e. when the colposcopy dept receives the referral direct from the cytology lab).

Where patients are not directly referred to lab i.e. the referrals go via the GP the patients would no longer be part of the screening cohort i.e. if the GP does a 2ww referral they are part of the original 2ww / 62 day pathway as they always had been prior to GFOCW (day 0 starts with receipt of referral by colposcopy etc.).

If the patient had low risk cytology the screening programme would refer back to the GP. The GP would not need to do a 2ww referral for such patients but it would be possible to do a consultant upgrade of such a referral if the consultant suspected cancer despite the low risk cytology.

The host of the screening service i.e. the provider commissioned to do the colposcopy will be responsible for uploading up to DATE FIRST SEEN irrespective of whether or not the patient was diagnosed with cancer.

The organisation commissioned to treat the patient is responsible for uploading the second part of the pathway i.e. from decision to treat to first treatment?

If a patient is directly referred from cytology to colposcopy in Trust A, but they then subsequently decide to choose to be first seen at another Trust B, then the Trust where the patient is first seen i.e. the one commissioned to provide the service should upload the data.

The DATE FIRST SEEN refers to first appointment following referral (or recall) from (or by) a screening provider i.e. appointment for colpsocopy.

The starting point for the 62 day standard is ORIGINAL REFERRAL REQUEST RECEIVED DATE i.e. receipt of referral for a colposcopy appointment

It is the responsibility of the host organisation that has been commissioned to provide the service to upload all records up to DATE FIRST SEEN.

The host trust for NLBSS is Barnet and Chase Farm Trust, so BCF would need to upload these records on behalf of NLBSS, with appropriate mechanisms in place to capture and transfer this data between the two organisations.

To distinguish these patients from those seen in BCF’s capacity as a conventional NHS provider, code 17 (a National Screening Programme) should be used in SOURCE OF REFERRALS FOR OUTPATIENTS.

The organisation commissioned to treat the patient is responsible for uploading the second part of the pathway i.e. from decision to treat to first treatment.

For example, Barnet & Chase Farm as the host provider is commissioned to provide the breast screening service; they are responsible for uploading the data up to DATE FIRST SEEN.

If BCF has been commissioned to provide the treatment they are responsible for uploading this activity.

Performance figures would appear under the accountable provider ie. if the provider was commissioned to see the patient (DATE FIRST SEEN) and treat the patient (TREATMENT START DATE (CANCER)) the ‘whole’ patient is recorded against their organisation. If they were only responsible for one part of the pathway (ie. just DATE FIRST SEEN or just TREATMENT START DATE (CANCER)) then they will be responsible for 0.5 of the patient ie. performance is apportioned.

The DATE FIRST SEEN refers to first appointment following referral (or recall) from (or by) a screening provider i.e. appointment for further assessment following screening mammogram. In North London, this happens within NLBSS.

GPs are not directly involved in the delivery of the NHS Bowel Cancer Screening Programme but they will be notified when invitations for bowel cancer screening are being sent out in their area. They will also receive a copy of the results letters sent to their patients.

It is the responsibility of the host organisation that has been commissioned to provide the service to upload all records up to DATE FIRST SEEN.

The host trust for bowel screening is University College Hospital and they will be responsible for uploading until DATE FIRST SEEN.

The organisation commissioned to treat the patient is responsible for uploading the second part of the pathway i.e. from decision to treat to first treatment.