WINNER - A collaboration between the Wales Cancer Network and all Welsh Health Boards: A partnership approach to establish Rapid Diagnosis Clinics (RDCs) across Wales

Wales Cancer Network

For Primary Care, the nature of presenting symptoms is critical in influencing decisions on patients’ route to referral and associated waits for diagnostic and treatment interventions. 50% of patients with cancer in UK general practice do not present with red flag symptoms and do not fit the Urgent Suspected Cancer referral criteria. Based on international examples of improved patient outcomes and experience for this vulnerable group, the Rapid Diagnosis Clinic (RDC) Programme was established in 2021 to support the implementation of RDCs and set the ambitious target that all Welsh Health Boards would have access to an RDC by the end of March 2023.

Before the introduction of RDCs, a GP would arrange a series of often uncoordinated diagnostic investigations or chosen a specialty to refer to, which may not have been appropriate for their eventual diagnosis. In some cases, referrals would be downgraded leading to delayed, uncoordinated, repeated investigations and patients being “bounced” between Multi-Disciplinary Teams, resulting in delayed diagnoses and poor patient outcomes and experience.

Building on successful Welsh Pilots, the Cancer Network Board approved the funding and establishment of a national RDC Programme. Working with colleagues across NHS Wales, including Health Boards, Improvement Cymru, Wales Cancer Alliance, Digital Health and Care Wales, Health Education and Improvement Wales, Welsh Government, patients, academics, and other national Programmes (e.g., Imaging) the Wales Cancer Network were able to implement a nationally driven but locally delivered RDC model.

This collaborative approach was the foundation of the programme and enabled co-design of a National Optimal Pathway, Service Specification, and a national patient experience survey, assuring the RDC model is equitable and accessible for the population in Wales. Data from April 2022 to March 2023 demonstrates that the service model assures a personalised, accurate, and rapid diagnosis of patients’ symptoms. Integrating diagnostic provision with a networked multidisciplinary team has enabled earlier diagnoses and onward management, while promoting improved patient outcomes and experience.