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62 day performance

62 day performance. John Wayman North Cumbria. 62 Day performance 2012 (Upper GI). Upper GI Cancer pathway. Upper GI Cancer pathway. 14 days. Upper GI Cancer pathway. 14 days. Upper GI Cancer pathway. 14 days. 14 days. Upper GI Cancer pathway. 7 days. 14 days. 14 days.

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62 day performance

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  1. 62 day performance John Wayman North Cumbria

  2. 62 Day performance 2012 (Upper GI)

  3. Upper GI Cancer pathway

  4. Upper GI Cancer pathway 14 days

  5. Upper GI Cancer pathway 14 days

  6. Upper GI Cancer pathway 14 days 14 days

  7. Upper GI Cancer pathway 7 days 14 days 14 days

  8. Upper GI Cancer pathway 7 days 14 days 14 days

  9. Upper GI Cancer pathway 7 days 14 days 14 days

  10. Upper GI Cancer pathway 7 days 7 days 14 days 14 days

  11. “Further Investigations”

  12. “Further Investigations” <20days?

  13. Why are we missing 62 day target? Nationally Locally Limited capacity CT USS MRI Bronchoscopy Endoscopy Reliance on other providers EUS C-PEX PET CT EMR • Long, multi-step pathway Diminishing performance of steps: “Step” “Pathway” • 95% 95% • 95% 90% • 95% 85% • 95% 80%

  14. Saving time • Solutions • >95% OGD within 7 days • >95% CT within 7 days • Investigate in parallel • Provide EUS and PET in house • Staging Admission • Remove MDT re-visits from pathway (Investigated to Protocol) • Risks • Capacity? • Capacity? • Over investigation • Cost of equipment and expertise • Capacity? • Exclude specialist interpretation of results and insufficient CNS support to co-ordinate

  15. Suggestions? • Agree protocols for local MDT’s for • PET/Bone scan • EUS • Neck USS • Bronchoscopy • C-PEX • Discuss at specialist MDT only after all investigation complete (or a result which “stops” the curative pathway) • Combine investigations • EUS + Neck USS + C-PEX/Anaesthetic assessment • Other Suggestion??

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