Impact of an ACP and CNS Led Triage Service on 28-Day Faster Diagnosis Standard Performance in Patients Referred with Suspected Oesophagogastric Cancer

Abstract Aim The volume of patients referred on the Upper GI 28-day Faster Diagnosis Standard Pathway (28-day FDS) continues to increase. Following recruitment of an advanced clinical practitioner (ACP), 2 clinical nurse specialists (CNS) and a pathway navigator, a dedicated telephone and face-to-face triage clinic and virtual results review and dissemination session (‘switch off’) was introduced to address this. A retrospective audit was conducted to review the impact of this change on 28-day FDS compliance (75% patients receiving oesophagogastric cancer diagnosis or exclusion). Method Retrospective data was collected on all UGI 28-day FDS referrals over two 3-month periods from January to March 2024 (Group 1: prior to the introduction of the ACP and CNS Led triage clinic) and between January and March 2025 (Group 2: following its implementation). Outcome data was collected on time to first clinical review, and 28-day FDS compliance. Results The mean number of monthly referrals was 145 in Group one versus 157 in Group 2. There was reduction in the meantime to first clinical review in Group 2 (5.0 vs 3.4 days), but mean monthly 28-day FDS compliance remained similar (78% vs 79%). However, monthly 28-day compliance was more consistently achieved in Group 2 (67% vs 100%) Conclusions Implementation of an ACP/CNS led triage service has led to both a reduction in the time to first clinical review and more consistent UGI 28-day FDS compliance. Further work is required to see if implementation of ACP/CNS ‘switch off sessions improve overall UGI 28-day compliance.