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Cancer Innovation and Improvement Programme

Post-Menopausal Bleeding Clinic: One stop ‘see and treat’ service

Caryl Thomas, Anju Sinha, Nigel Davies and Rhodri John

Cardiff and Vale University Health Board

Our project’s predominant aim was to improve the quality of care and reduce the waiting times to reach a diagnosis for patients presenting with suspected endometrial cancer on the Single Cancer Pathway. Current Welsh Government targets aim to diagnose and start cancer treatment within 62 days of the point of suspicion (the date of primary referral). As part of the Single Cancer Pathway, NHS Wales National Optimal Pathways (NOPs) recommend as good practice that histopathology diagnosis of cancer and staging by imaging should be performed within 28 days from the point of suspicion.

Project Objectives:

  1. Work with colleagues, the health board, Bevan commission and patients to co-design the new service.
  2. Provide an efficient ‘one-stop’ service for patients to improve the patients’ experience and to reduce the number of hospital appointments required in order to reach a diagnosis.
  3. Improve the early part of the Single Cancer Pathway – improving the diagnostic pathway by reaching a diagnosis in a more timely manner.

Project Outcomes:

To set up a new and improved ‘one stop’ PMB service in Cardiff & Vale health board in order to facilitate a timelier diagnosis of endometrial cancer and to provide reassurance quicker for those who have normal histopathology reports.

Project Impact:

Since the introduction of the one stop post-menopausal bleeding clinic, we have seen overall improvements in the time taken to reach a diagnosis (RTT) or downgrade results which are benign for patients with suspected endometrial cancer.

The feedback received from patients has been very positive. Patients prefer a ‘one stop’ approach, avoiding the need to create further delays and minimising the rneed for multiple appointments. We consistently received very positive feedback about our clinic staff, which helps to promote positive change within the department. The project has allowed us to provide timely diagnoses of endometrial cancer, reassure those who have had normal results and reduce the number of hospital visits required for patients.