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New service for those with bowel cancer symptoms

22 June 2021


A new service that aims to see those with Bowel Cancer symptoms more quickly has been set up at the James Paget University Hospital – and has already halved the time in which some patients are being diagnosed.

Previously if a patient saw their GP with symptoms suspicious of bowel cancer and their doctor wanted to refer them for further investigation, they would have been seen at our hospital clinic within about two weeks and would then be called in for tests such as a colonoscopy or CT scan before being reviewed by a multi-disciplinary team. This process might take several weeks from referral to diagnosis. 

The new Colorectal Straight To Test service aims to ensure patients with symptoms are diagnosed much more quickly, with some of the first on the new pathway going from referral to diagnosis in just 22 days. A quicker diagnosis can mean faster progress to treatment, or surgery at our hospital, and lead to better patient outcomes.

Patients who visit their GPs with symptoms that need further investigation are electronically referred and then triaged by Clinical Nurse Specialist Sister Rebecca Brown or Colorectal Sister Rachel Atkins. They look at what symptoms are reported and other factors, including age and general health, to see if the patient is suitable for Straight to Test or whether it would be more appropriate for them to attend our clinic in the first instance. 


Clinical Nurse Specialist Sister Rebecca Brown and Colorectal Sister Rachel Atkins - both wearing dark blue uniforms - pictured standing outside with a pale grey wall and window behind them

Clinical Nurse Specialist Sister Rebecca Brown and Colorectal Sister Rachel Atkins


Following this specialist nurse-led triage, patients who would benefit from Straight To Test are contacted and booked in immediately. 

The new service has been planned for some time but was delayed by the Covid-19 pandemic and was officially launched on Monday 26 April this year. In the first month of the service over 198 patients have been triaged, with 41 following the Straight To Test pathway.

In 97% of cases patients were triaged on the same day as the referral – the others were all triaged within three days, i.e. by the next working day when a referral was received later on a Friday. 

The first patient to follow the new pathway was referred on April 26, was triaged and phoned on the same day. They were then booked for a colonoscopy in our Endoscopy department on May 5, a CT scan on May 13 and were reviewed on 17 May before the diagnosis was given – a total time of 22 days from referral to diagnosis.

Consultant Colorectal Surgeon and Colorectal Cancer Lead Dr Kamal Aryal (centre) with Cancer Transformation Project Manager Katrina Strak (left) and Colorectal Sister Rachel Atkins, outside the Colorectal team office

Consultant Colorectal Surgeon and Colorectal Cancer Lead Dr Kamal Aryal (centre) with Cancer Transformation Project Manager Katrina Strak (left) and Colorectal Sister Rachel Atkins


Consultant Colorectal Surgeon and Colorectal Cancer Lead Dr Kamal Aryal said the new service aimed to achieve a diagnosis and communication to patients within 28 days of referral.

“We know that it can be a worrying time, not knowing how serious symptoms may be or what may lie ahead, so making a diagnosis quickly can help patients in a number of ways. The new pathway can reduce the need for multiple hospital visits and if we have to progress to surgery, it is at an earlier stage, which gives a better outcome for patients.

“There are a number of reasons patients may not be suitable for the pathway, including the nature of their symptoms, their age and if they have other health conditions but for those that are assessed as being able to go straight to test this offers a faster route to treatment.

“I’d like to thank everyone who has been involved in getting this new service up-and-running including our colorectal nursing team and colorectal surgeons, Cancer Transformation Project Manager Katrina Strak, my colleagues Dr Lal and Dr Badreldin, the outpatient booking team, our departmental managers and our Endoscopy team. Without their support we wouldn’t be able to do this. 

“We are aiming to transform existing pathways to improve services for patients and it is very fulfilling to be able to implement changes that make a difference. It is a continuing journey, as this is a new service, with many things to improve, but this is a great achievement for our patients and our hospital.”

Colorectal Sister Rachel Atkins and Clinical Nurse Specialist Rebecca Brown said; “We’re really pleased that we can provide this service to patients. We usually make contact quite quickly after the referral and patients are often surprised to have been called within a day or so of seeing their GP. While it may be more appropriate for some patients to come into our clinic before having the tests, those who are suitable can really benefit from the Straight To Test pathway.

“It’s thanks to all of those involved in the cancer pathway team and the multi-disciplinary team that we are able to provide this service and we are grateful to all our colleagues for their support.”

Some of our Endoscopy team, five members of staff including specialist nurses and a doctor, all wearing masks, stand in a line in our endoscopy reception area

Our Endoscopy team who are integral to the Straight To Test pathway.