Term

Definition

Point of suspicion of cancer

All patients suspected of having a new primary cancer will be entered onto the pathway. This includes patients who have had a previous cancer and are now suspected of having a different primary (a new) cancer. 

All patients on the SCP are to be recorded from point of suspicion as defined in the guidance document Single Suspected Cancer Pathway Definitions – pathway start date http://www.walescanet.wales.nhs.uk/scp-key-documents

With suspensions/Without suspensions

RTT Guidelines define a suspension as:

A period during which the cancer clock is paused due to the patient being unavailable or medically unfit due to a co-morbidity to proceed to the next stage of the pathway.

It is important to be able to identify patient waits with and without suspensions; consequently reports should include those with and without suspensions applied. Initially it will be difficult to record suspensions for those patients on the nUSC pathway prior to a decision to treat. While systems are developed to capture all suspensions along the pathway it is expected that all patient waits be recorded with suspensions as per existing USC and nUSC reporting.

As health boards progress with the implementation of the single cancer pathway and move from retrospective reporting to prospective reporting, suspensions prior to the decision to treat should be captured.

1 Treated by USC-nUSC

Measure

Definition

USC Pathway:

Treated in target with suspensions

Treated in target without suspensions

Total treated

Information should be copied from the dataset used to complete the existing pro forma Monthly Cancer Target Monitoring Form - Urgent Suspected Cancer

This is the total treated in target recorded for the month in column Number of newly diagnosed cancer patients starting first definitive treatment this month AND within 62 days from receipt of referral - suspensions to be applied as per existing RTT and supplementary national guidance.

This is the total treated in target recorded for the month in column Number of newly diagnosed cancer patients starting first definitive treatment this month AND within 62 days from receipt of referral

This is the total recorded for the month in column Total number of newly diagnosed cancer patients starting first definitive treatment this month.

nUSC Pathway:

Treated in target with suspensions

Treated in target without suspensions

Total treated

Information should be copied from the dataset used to complete the existing pro forma Monthly Cancer Target Monitoring Form - 'Non' Urgent Suspected Cancer

This is the total treated in target recorded for the month in column Number of newly diagnosed cancer patients starting first definitive treatment this month AND within 31 days of diagnosis – suspensions to be applied as per existing RTT and supplementary national guidance.

This is the total treated in target recorded for the month in column Number of newly diagnosed cancer patients starting first definitive treatment this month AND within 31 days of diagnosis

This is the total recorded for the month in column Total number of newly diagnosed cancer patients starting first definitive treatment this month.

Single Cancer Pathway:

Treated in target with suspensions

Treated in target without suspensions

Total treated

The total number of patients who began treatment within target in the month within 62 days from the point of suspicion. Suspensions to be applied as per existing RTT and supplementary national guidance.

The total number of patients who began treatment within target in the month within 62 days from the point of suspicion.

The total number of patients treated in the month that were referred onto the SCP including those that exceeded the 62 day target. There is not an expectation for the number of referrals to correspond with the numbers treated in any particular month.

2 Treated by Tumour Site

Treated in target with suspensions

Treated in target without suspensions

Total treated

Percentage treated in target

with suspensions

Percentage treated in target without suspensions

As worksheet 1 ‘Treated by USC nUSC’ but for SCP only and categorised by tumour site. The sum of the tumour categories in these columns should be equal to the SCP Numbers Treated in Target with/without suspensions figures in worksheet 1.

As worksheet 1 ‘Treated by USC nUSC’ but for SCP only and categorised by tumour site. The sum of the tumour categories in this column should be equal to the SCP Total treated figure in worksheet 1.

Autopopulated (Treated in target with suspensions/Total treated) x 100

Autopopulated (Treated in target without suspensions/Total treated) x 100

3 Entry onto Pathway

Entered pathway

The total number of patients referred onto the single cancer pathway in the reporting month including those that are later downgraded or removed from the pathway, broken down by entry onto the pathway. These are patients starting from the point of suspicion as defined in Single Suspected Cancer Pathway Definitions – pathway start date http://www.walescanet.wales.nhs.uk/scp-key-documents. It is understood that all patients who are downgraded may not be captured at present until process changes are made. Until process changes are in place it is acceptable to use the date the patient record is downgraded (i.e. downgrade actioned on the system) as a proxy for the actual date of downgrade.

4 Treated by Entry onto Pathway

Treated in target with suspensions

Treated in target without suspensions

Total treated

Percentage treated in target

with suspensions

Percentage treated in target without suspensions

This is the same cohort of patients as in worksheet 1 ‘Treated by USC nUSC’ but for SCP only and categorised by source of entry onto the pathway. This is essential for understanding where the majority of patients are entering the pathway and which areas are problematic.

For further guidance please contact the Cancer Network via the email address below:

singlecancerpathway@wales.nhs.uk

The sum of the pathway categories in these columns should be equal to the SCP Numbers Treated in Target with/without suspensions figures in worksheet 1.

As worksheet 1 ‘Treated by USC nUSC’ but for SCP only and categorised by entry onto the pathway. The sum of the pathway categories in this columns should be equal to the SCP Total treated figure in worksheet 1.

Autopopulated (Treated in target with suspensions/Total treated) x 100

Autopopulated (Treated in target without suspensions/Total treated) x 100

5 Enter Pathway by Tumour Site

Total number of patients entering the pathway

The total number of patients referred onto the single cancer pathway in the reporting month including those that are later downgraded or removed from the pathway, broken down by tumour site. These are the same cohort of patients as Worksheet 3 ‘Entry onto pathway’ but by tumour site. It is understood that all patients who are downgraded may not be captured at present until system changes are made. Until system changes are in place it is acceptable to use the date the patient record is downgraded (i.e. downgrade actioned on the system) as a proxy for the actual date of downgrade.

6 Informed Date by Tumour Site

Total with diagnosis informed date

Total with diagnosis informed date

within 28 days

Percentage with informed date within 28 days

This cohort consists of patients who have been informed of their confirmed diagnosis.

This count is attempting to capture the date on which they were informed in the reporting month regardless of which month they entered the SCP or whether they have begun treatment or not.

If current systems are unable to capture the date the patient is informed of their diagnosis then the decision to treat date or date the patient is downgraded should be used in the short term while work is progressed to make the necessary changes on systems.

This cohort consists of patients who have been informed of their confirmed diagnosis.

This count is attempting to capture the number of patients who were informed of their diagnosis within 28 days in the reporting month regardless of which month they entered the SCP or whether they have begun treatment or not.

If current systems are unable to capture the date the patient is informed of their diagnosis then the decision to treat date or date the patient is downgraded should be used in the short term while work is progressed to make the necessary changes on systems.

This cohort consists of patients who have been informed of their confirmed diagnosis.

This percentage is attempting to capture the number of patients who were informed of their diagnosis within 28 days in the reporting month regardless of which month they entered the SCP or whether they have begun treatment or not.

Autopopulated (Total with end date within 28 days /Total with diagnosis end date) x 100