Symposia & Podium Abstracts

Background: Patients referred on a cancer pathway may experience psychological harm and distress whilst waiting for test results for diagnosis and treatment. Clinical harm is assessed regarding cancer waiting time breaches.Psychological harm is rarely assessed, if at all. In May 2021, a North Central London workshop identified psychological harm as an area to prioritise in cancer pathways.Whilst the project is sponsored by NCL, engagement has taken place pan London. Aims:1. Explore 'psychological harm' caused by waiting for diagnostics and first treatment 2. By understanding the impact of psychological harm, produce recommendations to improve patient care. Methods: A literature review was conducted regarding cancer and psychological harm and distress whilst waiting for tests.This did not include screening. Twelve semi-structured focus groups and interviews were held with patients, carers, psycho-oncologists, cancer nurses, cancer support workers, cancer GPs, practice nurses and a cancer surgeon.36 people participated, and thematic analysis of transcripts was conducted. A stakeholder workshop was held in November 2022 which sought to understand the findings of the literature scan and focus groups, as well as identify pragmatic next steps to improve the diagnostic pathway for the psychological wellbeing of patients.Results/Conclusions: Assessing psychological harm is complex and not comparable to assessing clinical harm on a cancer diagnostics pathway.NHS services should be pro-active, personalised and prioritise minimising distress and promoting adjustment for both patient and family.Principles identified for service improvements included: consistent, efficient and clear information and communication builds trust and reduces distress. providing named contact on receipt of referral from the start, explore emotional impact of referral, diagnostics and treatment process and potential obstacles to engagement. manage expectations about the pathway proactively identify needs and reasonable adjustments, at time of booking appointments involve family from the start & offer psychological interventions for families/significant others.