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Patients referred under UGI 2WW

Study compares direct access and standard 2WW pathways for UGI patients at NUH, highlighting time to first contact, test requests, and cancer diagnoses. Findings support efficient exit strategies.

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Patients referred under UGI 2WW

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  1. Patients referred under UGI 2WW

  2. Time to first contact at NUH: OGD No difference between pilot direct access and standard 2WW p > 0.05

  3. Time to first contact at NUH: clinic No difference between pilot direct access and standard 2WW p > 0.05

  4. Time to first contact at NUH

  5. Tests requested after clinic: standard UGI 2WW

  6. Time on UGI 2WW pathway

  7. Time on UGI 2WW pathway Exit from UGI 2WW pathway may involve: • test(s) undertaken to diagnose patient’s symptoms • test(s) performed to exclude oesophago-gastric cancer

  8. Time on UGI 2WW pathway No difference between pilot direct access and standard 2WW p > 0.05

  9. Time on UGI 2WW pathway Quicker exit time from UGI 2WW pathway if only contact is straight-to-test OGD -> Caveat: test to exclude OG cancer

  10. Time on UGI 2WW pathway Quicker exit from UGI 2WW pathway along standard UGI 2WW p < 0.05

  11. Time on UGI 2WW pathway

  12. Cancer diagnoses UGI 2WW pathway

  13. Cancer diagnoses UGI 2WW pathway

  14. Cancer diagnoses post-exit from UGI 2WW pathway

  15. Complications post-exit from UGI 2WW pathway

  16. Death post-exit from UGI 2WW pathway

  17. Emergency presentation resulting in a diagnosis of cancer at NUH in 2014 Number of cancers diagnosed following emergency admission to NUH Postcode

  18. Postcode distribution? Proportion %

  19. Conclusions • Vetting at hospital stage is not rate limiting step in exit from pathway

  20. Conclusions • Vetting at hospital stage is not rate limiting step in exit from pathway • Cancers identified by GP-requested DTT OGD were not oesophago-gastric but required further tests

  21. Conclusions • Vetting at hospital stage is not rate limiting step in exit from pathway • Cancers identified by GP-requested DTT OGD were not oesophago-gastric but required further tests • UGI 2WW pathway more frequently diagnoses cancer outside of oesophago-gastric tract [which cannot be diagnosed by OGD alone]

  22. Conclusions • Vetting at hospital stage is not rate limiting step in exit from pathway • Cancers identified by GP-requested DTT OGD were not oesophago-gastric but required further tests • UGI 2WW pathway more frequently diagnoses cancer outside of oesophago-gastric tract [which cannot be diagnosed by OGD alone] • There is a postcode variation in 2WW suspected cancer referrals and emergency cancer diagnoses but this is complex

  23. Conclusions • Vetting at hospital stage is not rate limiting step in exit from pathway • Cancers identified by GP-requested DTT OGD were not oesophago-gastric but required further tests • UGI 2WW pathway more frequently diagnoses cancer outside of oesophago-gastric tract [which cannot be diagnosed by OGD alone] • There is a postcode variation in 2WW suspected cancer referrals and emergency cancer diagnoses but this is complex

  24. Nina R Lewisnina.lewis@nuh.nhs.uk0115 9691169 Extension 56335Fax: 0115 8405821

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