Differential triage in the postmenopausal bleed clinic; getting it right the first time, effect on single cancer pathway

ObjectiveTo reduce waiting time in PMB clinics, and patient journey on Single cancer pathway.DesignDifferential triage based on risk stratification in USC PMB clinics. Patients with true PMB and with unscheduled bleeding on HRT with risk factors triaged to 2WW. Those with unscheduled bleeding on HRT without risk factors to 6WW clinic. Introduced from March 2024 onwards. Data analysed over 4 months.SettingOne stop PMB clinics, Large DGH in Newport, Wales Population: Aneurin Bevan Health board Hospitals with a population of 600,000.Main outcome measuresTime to first outpatient appointment.ResultsNine hundred and two referrals. 48.22% were not on HRT. 49.88 % were on HRT. 20.44% were on HRT with risk factors. The first outpatient appointment improved from 17.6% in April to 64.6% (<i>p</i> < .0001) in September. Patients breaching the Single Cancer Pathway went down from 11 in April to 2 in September. 88% patients discharged after the FOA. One hundred and ninety-two (21.28%) had a hysteroscopy polypectomy. Forty-four cancers in the true PMB group and 1 cancer in the HRT group. There was no difference in the average BMI between the cancer and benign patients. Patients with endometrial cancer were significantly older (<i>p</i> < .0001***).ConclusionDifferential triage has reduced the waiting times in PMB clinics.