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Patients referred under UGI 2WW

Patients referred under UGI 2WW. Time to first contact at NUH: OGD. No difference between pilot direct access and standard 2WW p > 0.05. Time to first contact at NUH: clinic. No difference between pilot direct access and standard 2WW p > 0.05. Time to first contact at NUH.

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Patients referred under UGI 2WW

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  1. Patients referred under UGI 2WW

  2. Time to first contact at NUH: OGD No difference between pilot direct access and standard 2WW p > 0.05

  3. Time to first contact at NUH: clinic No difference between pilot direct access and standard 2WW p > 0.05

  4. Time to first contact at NUH

  5. Tests requested after clinic: standard UGI 2WW

  6. Time on UGI 2WW pathway

  7. Time on UGI 2WW pathway Exit from UGI 2WW pathway may involve: • test(s) undertaken to diagnose patient’s symptoms • test(s) performed to exclude oesophago-gastric cancer

  8. Time on UGI 2WW pathway No difference between pilot direct access and standard 2WW p > 0.05

  9. Time on UGI 2WW pathway Quicker exit time from UGI 2WW pathway if only contact is straight-to-test OGD -> Caveat: test to exclude OG cancer

  10. Time on UGI 2WW pathway Quicker exit from UGI 2WW pathway along standard UGI 2WW p < 0.05

  11. Time on UGI 2WW pathway

  12. Cancer diagnoses UGI 2WW pathway

  13. Cancer diagnoses UGI 2WW pathway

  14. Cancer diagnoses post-exit from UGI 2WW pathway

  15. Complications post-exit from UGI 2WW pathway

  16. Death post-exit from UGI 2WW pathway

  17. Emergency presentation resulting in a diagnosis of cancer at NUH in 2014 Number of cancers diagnosed following emergency admission to NUH Postcode

  18. Postcode distribution? Proportion %

  19. Conclusions • Vetting at hospital stage is not rate limiting step in exit from pathway

  20. Conclusions • Vetting at hospital stage is not rate limiting step in exit from pathway • Cancers identified by GP-requested DTT OGD were not oesophago-gastric but required further tests

  21. Conclusions • Vetting at hospital stage is not rate limiting step in exit from pathway • Cancers identified by GP-requested DTT OGD were not oesophago-gastric but required further tests • UGI 2WW pathway more frequently diagnoses cancer outside of oesophago-gastric tract [which cannot be diagnosed by OGD alone]

  22. Conclusions • Vetting at hospital stage is not rate limiting step in exit from pathway • Cancers identified by GP-requested DTT OGD were not oesophago-gastric but required further tests • UGI 2WW pathway more frequently diagnoses cancer outside of oesophago-gastric tract [which cannot be diagnosed by OGD alone] • There is a postcode variation in 2WW suspected cancer referrals and emergency cancer diagnoses but this is complex

  23. Conclusions • Vetting at hospital stage is not rate limiting step in exit from pathway • Cancers identified by GP-requested DTT OGD were not oesophago-gastric but required further tests • UGI 2WW pathway more frequently diagnoses cancer outside of oesophago-gastric tract [which cannot be diagnosed by OGD alone] • There is a postcode variation in 2WW suspected cancer referrals and emergency cancer diagnoses but this is complex

  24. Nina R Lewisnina.lewis@nuh.nhs.uk0115 9691169 Extension 56335Fax: 0115 8405821

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