Olly Hulson

My Topol fellowship problem / project:

Referrals to the 2 week wait service for suspected prostate cancer have increased fourfold in 2 years. Discounting the drop in referrals during the pandemic, we have seen a year-on-year increase in requests for prostate MRI scans and prostate biopsy for over 10 years. The service has now reached a tipping point, with men waiting on average 30 days from referral to their MRI appointment, 30 days from their MRI to their biopsy appointment, and 30 days from their biopsy to receiving their results. Treatment, if required, can typically only be commenced after this, and often will not start for some time later. This falls way below the 62-day standard from referral to treatment, and is a far cry from the 28 day ‘best practice’ timed pathway recently championed by NHS England. If we are to improve patient throughput, we must reduce the friction along the pathway and deliver a seamless, patient-centred service. Much of this friction arises from the numerous touchpoints required between the patient and the clinical team on their journey. Each clinician-patient interaction obviously adds a delay. If we can identify those patients, at the point of referral (based on information provided by their GP) who would benefit from an accelerated pathway (that is straight to MRI, and onwards to biopsy without the need for clinical review in between) then we can reduce their journey significantly, and make the pathway much more efficient. This problem is not unique to my hospital trust, nor is it unique to the prostate cancer pathway. As such, if a digital technology solution is achievable, this would not only be transferable to other hospitals, but also translatable to other suspected cancer pathways, all of which are struggling to cope with capacity, demand and throughput.