Barts Health NHS Trust for Non-Specific Symptom (NSS) referrals
Barts Health has undertaken a review of the sustainability of the Rapid Diagnostic Clinic (RDC) which was originally set up as a pilot in 2020. As part of this review over the last 6 months, we have seen 44% of referrals returned to provider with advice and we have observed a number of patients already referred to site-specific pathways; for those seen by the RDC there has been an average 1.3% cancer conversion rate. Due to being unable to secure recurrent funding and therefore provide a safe model of staffing, Barts will be looking to close the service that is currently provided from the Royal London Hospital by end of September. Please see timeline below of service closure:
We apologise for the impact this may have, and we fully understand the worries and concerns that this brings to you, your patients and their families. In conjunction with Cancer Alliance and GP PLACE cancer leads, we have set out the below principles for those patients that may have been referred into the RDC or intend to be. The NEL Cancer Alliance GP leads and PLACE cancer GP leads are aware of this change and have helped to ensure we provide you with information to manage your patients.
In the absence of the RDC, we encourage practices to continue to seek the most appropriate direct access pathway for their patient by using:
- an Urgent Suspected Cancer Pathway or
- Direct Access Diagnostics
Please find information on alternative referral routes below:
| Alternative Referral Routes/Pathways |
| Direct access diagnostic pathways – Early Cancer Diagnosis PCN DES and QOF Support Guide July 2024.pdf Barts Health GP Direct Access to CT for Suspected Pancreatic Cancer – North East London City & Hackney Direct Access CT for Unintentional Significant Weight Loss Another suspected cancer pathway (e.g. upper GI for abdominal pains/anaemia, etc) https://www.gatewayc.org.uk/cancer-maps/ |
To help prevent delays in a suspected cancer pathway, Filter function tests should be used to support a diagnosis and help refer patients via a site-specific route if appropriate. This reduces the risk of test duplication later in a patient’s pathway and ensures all necessary pre-investigations (e.g. kidney function) have been completed, removing potential delays further along the pathway. A filter function test bundle, named “RDC NSS Pre-Referral Test Bundle”, has been created on the pathology ordering systems (T-Quest and Cyberlab Guide) which can still be used to aid diagnosis.
| ‘RDC NSS Pre-Referral Test Bundle’ includes: | |||
| FBC | U&Es with eGFR | Protein Electrophoresis (Serum EP) | HbA1c |
| CRP | LFTs | TSH | Bone |
| PSA (male only) | CA12-5 (female only) | B12 | Ferritin |
| Folate | FIT | ||
You may also wish to consider ordering the following ‘optional’ tests as recommended by the Faster Diagnosis Framework where clinically indicated:
| ‘RDC NSS Optional Tests’ include: | |||
| Coeliac serology | LDH | GGT | HIV |
| Hep B/C serology | Clotting (for lymphadenopathy referrals) | glucose | |
If you require an update on a patient already referred onto the NSS pathway, please do contact us: