2 week wait letter for GP - Royal Shrewsbury Hospitals NHS Trust

The <strong>Royal</strong> <strong>Shrewsbury</strong> HospitalMytton Oak Road<strong>Shrewsbury</strong>SY3 8XQ01743 261000 ex 26471 April 2009Dear ColleagueRe: 2 Week Wait ReferralsI am writing to advise you that the guidance on <strong>wait</strong>ing <strong>for</strong> cancer investigations makes it clear thatthe 2 <strong>week</strong> <strong>wait</strong> clock can no longer be paused to allow <strong>for</strong> patient choice or medical suspensions.The suggested per<strong>for</strong>mance threshold <strong>for</strong> the 2 <strong>week</strong> <strong>wait</strong> target has been reduced from 98% to 93%to allow <strong>for</strong> patient choice of appointment date.However, it appears that some patients are declining the offer of a choice of appointments within the2 <strong>week</strong> <strong>wait</strong> rule. The most common reason is that patients are preferring to <strong>wait</strong> <strong>for</strong> a date at thehospital site nearest to where they live, or that they are unavailable <strong>for</strong> the appointment due toholiday commitments at the time of the referral.The guidance states that referral protocols are <strong>for</strong> local determination and agreement. Followingdiscussion between The <strong>Shrewsbury</strong> and Tel<strong>for</strong>d Hospital <strong>NHS</strong> <strong>Trust</strong> and Shropshire County PCTMedical Director, Dr Jane Povey, agreement was reached at the LMC to help address this difficulty,as noted below:To ensure that patients are given plenty of notice about appointment dates, they will becontacted within 48 hours of referral with the offer of a choice of appointments within the 14day target.Patients will be contacted on a preferred contact phone number during working hours orduring the evening.Urgent 2 <strong>week</strong> <strong>wait</strong> site-specific referral pro<strong>for</strong>mas have been revised to enable:a) referring <strong>GP</strong>s to provide patients’ preferred contact details <strong>for</strong> daytime and eveningb) patients to phone the 2 <strong>week</strong> <strong>wait</strong> office on the contact number noted on each pro<strong>for</strong>ma<strong>Trust</strong> web site: www.sath.nhs.uk

c) the referring <strong>GP</strong> to indicate if the importance of the referral has been discussed with thepatient, in accordance with the referral guidelines <strong>for</strong> suspected cancer (NICE guidance,2005).Where a patient declines the offer of an appointment within the 2 <strong>week</strong> <strong>wait</strong> rule, thereferring <strong>GP</strong> will be telephoned by a 2 <strong>week</strong> <strong>wait</strong> clerk to agree whether the <strong>GP</strong> wants tocontact the patient to persuade them to accept the appointment date or whether the <strong>GP</strong>wants the patient to be seen as an urgent referral and not as a 2 <strong>week</strong> <strong>wait</strong> patient. The 2<strong>week</strong> <strong>wait</strong> clerk will in<strong>for</strong>m the <strong>GP</strong> of the date of the urgent appointment that will be offeredto the patient.An initial pilot will be implemented to ensure that any patient whose referral is changed froma 2 <strong>week</strong> <strong>wait</strong> to an urgent appointment, is tracked <strong>for</strong> governance purposes.There have been some difficulties recently within the 2 <strong>week</strong> <strong>wait</strong> office due to sickness, which hasbeen compounded by the seasonal increase in 2 <strong>week</strong> <strong>wait</strong> referral demand.Additional resources have been provided to the 2 <strong>week</strong> <strong>wait</strong> service to address these difficulties, andthe 2 <strong>week</strong> <strong>wait</strong> office opening hours have been extended to enable the clerks to phone patients from0800 until 1930.I hope that <strong>GP</strong>s and practice managers will see an improvement in the 2 <strong>week</strong> <strong>wait</strong> service followingthese changes.May I please urge <strong>GP</strong>s to kindly use the revised 2 <strong>week</strong> <strong>wait</strong> site-specific pro<strong>for</strong>mas, which havebeen issued to practices.If you require any further in<strong>for</strong>mation or experience ongoing difficulties please contact Alison Trumper(Nurse Manager/Matron Oncology/Haematology) to discuss, on 01743 261000 ext 2647, [email protected] SincerelyDr R HattsClinical Director Cancer Services<strong>Trust</strong> web site: www.sath.nhs.uk