'Two week wait' standards for suspected gynaecological malignancy. On target, but missing the point?

Area of Science:

• Oncology
• Gynaecology
• Healthcare Management

Background:

• The UK introduced a two-week rapid access referral system in April 2000 for suspected gynecological cancers.
• This system aimed to expedite diagnosis and treatment for women presenting with concerning symptoms.

Purpose of the Study:

• To assess the effectiveness and impact of the two-week rapid access referral system for gynecological cancer in the UK.
• To evaluate waiting times and diagnostic outcomes for patients referred through the rapid access system compared to routine referrals.

Main Methods:

• An audit was conducted on women referred via the two-week rapid access system to a gynecological oncology surgeon between April 2000 and March 2003.
• Data collected included waiting times, clinical indications for referral, and subsequent diagnoses.
• Information on patients diagnosed with gynecological malignancy via routine outpatient referrals during the same period was also gathered.

Main Results:

• The two-week target for consultant appointments was achieved for 94% of women referred through the rapid access system.
• A slight decline in response time was observed as the number of referrals increased.
• Crucially, the majority of women diagnosed with gynecological malignancy were not referred via the rapid access system.

Conclusions:

• While the rapid access system met its appointment targets, it did not capture the majority of gynecological cancer cases.
• Accommodating rapid access referrals led to reduced appointments for routine referrals.
• There is a risk of delayed diagnoses for women with gynecological malignancy who present through traditional referral pathways.