TET Phase 1 - Prostate and Breast Cancer
Phase 1 of the Test Evidence Transition programme launched in April 2023 in Scotland and Wales, supporting three NHS teams collaborating with academic partners to improve breast cancer and prostate cancer pathways. These projects are:
- PROSTAD: Development of Model Prostate Cancer Diagnostic Pathway – Hywel Dda University Health Board, TriTech Institute & Swansea University, Wales
- Access to Breast Cancer Assessment Clinics without GP Appointment – NHS Forth Valley and University of Stirling, Scotland
- Rapid Access Referrals for Prostate Cancer: A Nurse-Led Model for Suspected Prostate Cancer Referrals – NHS Fife and University of Stirling, Scotland
Phase 1 has been supported by the Royal London Insurance Group as part of their commitment to tackling cancer inequalities.
Our Phase 1 projects
PROSTAD: Development of Model Prostate Cancer Diagnostic Pathway – Hywel Dda University Health Board, TriTech Institute & Swansea University, Wales
Project Leads:
- Rachel Gemine – Evaluation Lead, TriTech Institute, Hywel Dda University Health Board
- Mr Yeung Ng - Consultant Urologist, Hywel Dda University Health Board
- Jaynie Rance – Professor of Health Psychology, Swansea University
Overview:
PROSTAD aims to develop, pilot, and evaluate implementation of a model prostate cancer diagnostic pathway within NHS Wales to improve optimal cancer pathway arrangements by shortening time from referral to diagnosis. The project implements a new diagnostic pathway aiming to shorten the cancer pathway and incorporate gold standard techniques, including a two-stage diagnostic clinic for prostate MRI with next day reporting and dedicated biopsy clinics with specialist nurse support to establish joint clinics and reduce known delays. The introduction of the mpMRI may reduce the need for biopsies by increasing diagnostic accuracy, and implementing the most up to date biopsy technique will reduce discomfort for patients and the risk of infection. Project completion is due December 2024.
Media Coverage:
- Western Telegraph. 'Cancer Research UK funds Hywel Dda prostate cancer scheme'.
- Moondance Cancer Initiative. 'Moondance Cancer Awards 2024 Shortlist'.
- Swansea Bay News. ‘Local Swansea prostate cancer initiative wins national award’.
The Prostad pathway explores the role of straight to optimal test imaging (multi parametric MRI) and local anaesthetic transperineal (LATP) biopsies, enabling accurate diagnosis and reducing the need for additional tests and minimising delays in the pathway. We are very excited to be working with Cancer Research UK, as part of the TET programme to develop a streamlined, more efficient and more effective pathway for those with suspected prostate cancer.
Rachel Gemine, Evaluation Lead at TriTech Institute, Hywel Dda University Health Board
Access to Breast Cancer Assessment Clinics without GP Appointment – NHS Forth Valley & University of Stirling, Scotland
Project Leads:
- Juliette Murray – Consultant Breast Surgeon and Deputy Medical Director, NHS Forth Valley
- Erica Gadsby – Associate Professor in Public Health, University of Stirling
Overview:
NHS Forth Valley and the University of Stirling are implementing a rapid access pathway to the one-stop breast assessment clinic for symptomatic patients who present to primary care with a breast lump. Patients who contact their GP with a breast lump will be referred directly to an assessment clinic, without need for an initial GP appointment and subsequent wait for referral. This aims to increase GP capacity, prevent delays in diagnosis and improve patient outcomes and experience. Project completion is due February 2025.
Publications and Media Coverage:
- Erica Gadsby, Jane Thomson, Juliette Murray et al. BMC Cancer. 'Test, evidence, transition projects in Scotland: developing the evidence needed for transition of effective interventions in cancer care from innovation into mainstream practice'.
- NHS Forth Valley. 'New Breast Cancer Fast-Track Diagnosis Scheme Launched'.
- Alloa Advertiser. 'NHS Forth Valley: Scheme launched to cut breast cancer waiting times'.
- The Scotsman. 'GPs bypassed in new Scottish pilot to speed up cancer diagnosis'.
- University of Stirling. 'Health experts to evaluate new fast-track cancer diagnosis scheme'.
- The Times. 'Scottish trials for faster NHS diagnosis of breast and prostate cancer'.
- Daily Mail. 'Receptionists refer patients for treatment in bid to cut cancer waiting times'.
We already run one-stop breast clinics which enable patients referred by their GP to have an outpatient consultation, mammogram and ultrasound scans performed during the same visit along with a biopsy, if required. Enabling GPs to refer directly to these clinics without the need for patients to attend their GP Practice for an initial consultation will make the referral process even faster. It will also ensure women who find lumps or experience changes in their breasts are seen as quickly as possible and, in many cases, reassured that they do not have cancer.
Juliette Murray, Deputy Medical Director at NHS Forth Valley
Rapid Access Referrals for Prostate Cancer: A Nurse-Led Model for Suspected Prostate Cancer Referrals – NHS Fife & University of Stirling, Scotland
Project Leads:
- Jane Thomson – Advanced Clinical Nurse Specialist, NHS Fife
- Erica Gadsby – Associate Professor in Public Health, University of Stirling
Overview:
NHS Fife are collaborating with the University of Stirling to implement a nurse-led, rapid access diagnostic clinic for suspected prostate cancer referrals. This model will support patients from referral to diagnosis, providing daily referral triage and a one-stop diagnostic investigation service. Once patients have been referred to the nurse-led team, patient navigators will support the Advanced Clinical Nurse Specialist (ACNS) in assessing patients, arranging scans, booking tests. The ACNS will interpret the results, discuss them with the patient, and present them to the multidisciplinary team to consider treatment options. This approach aims to improve the patients’ experience, reduce patient waiting times and enable clinical consultants to focus on the specialist diagnostic and treatment phases of the pathway. Project completion is due in February 2025.
Publications and Media Coverage:
- Erica Gadsby, Jane Thomson, Juliette Murray et al. BMC Cancer. 'Test, evidence, transition projects in Scotland: developing the evidence needed for transition of effective interventions in cancer care from innovation into mainstream practice'.
- NHS Fife. 'New initiative aims to fast-track cancer diagnosis'.
- The Scotsman. 'GPs bypassed in new Scottish pilot to speed up cancer diagnosis'.
- University of Stirling. 'Health experts to evaluate new fast-track cancer diagnosis scheme'.
- The Times. 'Scottish trials for faster NHS diagnosis of breast and prostate cancer'.
- Daily Mail. 'Receptionists refer patients for treatment in bid to cut cancer waiting times'.
- NHS Fife. 'Awards Ceremony Recognises Fife’s Healthcare Heroes'.
The development of a new advanced clinical nurse specialist rapid access diagnostic clinic for people with an urgent suspected prostate cancer has the potential to allow quicker access to diagnostic appointments, diagnostic tests, as well as earlier treatment decisions and management. This initiative also supports our aim to ensure that people with an urgent suspicion of prostate cancer receive the right care, at the right time, every time, and addresses what matters most to people.
Jane Thomson, Advanced Clinical Nurse Specialist at NHS Fife
Contact us
If you have any questions about the TET programme, please contact us at TET@cancer.org.uk.