Reducing waiting times in lung cancer

Concern exists over delays in the management of lung cancer patients. Maximum waiting times and a multidisciplinary team (MDT) approach have been recommended in several recent national reports.

Having implemented a MDT approach, we wished to assess whether national recommendations were achievable and to identify the major factors causing delays.

Prospective survey over five months of all new referrals with suspected lung cancer, documenting waiting times at all stages from referral to definitive treatment.

Of the total of 92 patients, 57 were outpatients (67% seen within one week, 89% within two weeks of receipt of referral) and 35 were inpatients (all seen within two working days). Patient age did not influence waiting times to first being seen or to investigation. The result of the initial diagnostic test was received within two weeks of first being seen in 86% of patients. All patients received definitive treatment within recommended times from diagnosis. Delays in the early part of the care pathway were largely due to potentially remediable service factors, but unavoidable patient related factors were important in some prolonged diagnostic delays.

National recommendations on waiting times are achievable in a high proportion of cases. The probable importance of the MDT approach is discussed.