Clinical nurse specialist-led digital rectoscopy: evaluation of a service improvement initiative

This service improvement initiative involved piloting a clinical nurse specialist (CNS)-led digital rectoscopy service for patients referred to the Faster Diagnosis Standard suspected colorectal cancer pathway (FDS pathway) at one trust in England. The effectiveness of the service was evaluated in terms of workforce efficiency and patient acceptability. Data were reviewed for 206 patients who had attended the CNS-led digital rectoscopy service over a ten-month period (intervention group) and for 100 patients who had been referred to the FDS pathway before implementation of the pilot (comparison group). While the proportion of patients diagnosed with benign disease and the proportion of those diagnosed with rectal cancer were similar in both groups, there had been fewer referrals for further investigations and consultant review in the intervention group. Patient feedback on the CNS-led digital rectoscopy service was strongly positive, with 90% of 84 respondents stating they were happy to be seen by a fully qualified CNS rather than a doctor. Overall, the evaluation showed that a CNS-led digital rectoscopy clinic can have benefits in terms of patient experience, service efficiency and the use of healthcare resources, and may contribute to reduced pressure on endoscopy services.