Nurse-led cancer team sees waiting times cut by 70%

Nurses at the urology and oncology departments of University Hospitals of Derby and Burton NHS Foundation Trust, in 2023, set up and led a combined prostate cancer triage and biopsy service to simplify, and hasten, the diagnosis of suspected prostate cancer.

“We knew there had to be a more efficient way of managing this and working to drive down the backlog”

Lucy Tuckwood

The service was created, in part, due to a backlog of patients following the Covid-19 pandemic, according to Royal Derby Hospital-based advanced clinical practitioner Lucy Tuckwood.

It acts as a single point of contact for patients, which helps them navigate complex hospital structures.

Since January 2023, when the service was first trialled, the average time between referral to biopsy has fallen by more than 70%, from 80 to 23 days. This is better than the national 28-day target.

Ms Tuckwood, head of her hospital’s triage team, said, before the service was set up, a “convoluted” process of getting to a biopsy for prostate cancer patients was part of the reason the backlog was not being cleared.

“We knew there had to be a more efficient way of managing this and working to drive down the backlog – so the nurse-led service was implemented in order to streamline that diagnostic pathway, speeding up the process and alleviating the anxiety associated with prolonged wait times for results,” said Ms Tuckwood.

“This leveraged the expertise of existing advanced and specialist nursing within our organisation, as well as equipping our team with new skills to deliver much of the process through a single place.”

Nursing staff within the teams are trained as experts in both prostate cancer triage and biopsy which, the trust said, facilitates faster diagnoses.

Patients who are referred, if they are able, can progress straight to an MRI scan without the need for multiple appointments with consultants under the new system.

A patient is then seen by a consultant for more investigations if necessary, while the triage team “pre-plans” for a biopsy as soon as it can, within days if possible.

As well as speeding up the process of diagnoses for patients who do have cancer, the trust said the service had also meant patients who do not are able to be “reassured and guided” to the right place.

Ms Tuckwood added: “Knowing [patients will] be looked after quickly, and that they have our team as a consistent point of contact throughout their journey has been crucial to making their experience as positive as we can.

“Providing clarity and support, and building a strong rapport, plays an enormous role in reducing the stress often associated with cancer investigations.”

She added that there was an ambition within the trust to further improve care, and said: “We are committed to our ultimate goal of getting patients the tests they need as quickly and efficiently as possible – and to ensure all patients feel confident in raising concerns, and knowing they are being looked after every step of the way.”