SP9.02 Comprehensive geriatric assessment for frail patients on a suspected cancer pathway decreases re-referrals

Background Straight-to-test (STT) protocols are routinely used on the lower gastrointestinal (LGI) Urgent Suspected Cancer (USC) pathway. This reduces diagnostic time and treatment delays. However, re-referrals still occur from primary care. We have previously shown that a comprehensive geriatric assessment (CGA) for frail patients on the LGI USC pathway provides more holistic and patient-centred care with fewer investigations. In this study, we demonstrate that it also reduces the number of re-referrals to the service. Methods A prospectively maintained database of all referrals on the LGI USC pathway between Jan ’22 and Feb ’24 was analysed. The frailty pathway received 292 referrals and outcomes were compared with all age-matched referrals (>75 years). Hospital records were checked to assess the number of re-referrals and outcomes up to October ’24. Results Of 292 patients referred to the LGI frailty pathway, 27 did not attend, 35 declined to proceed, 77 were unfit, 10 required optimisation, and 143 were suitable for further investigations. Up to Oct ’24, 6 patients (2%) were re-referred to the service; 2 had initially declined investigations and 4 were assessed as unfit to proceed. Comparatively, of 2542 patients (>75 years) on the USC pathway who did not require a frailty assessment, 275 (10.8 %) were referred to the pathway more than once. Conclusion A CGA on the LGI USC pathway provides personalised care and a more holistic approach for frail patients by increasing shared decision-making. It optimises resource management by reducing the number of unnecessary investigations and re-referrals to USC pathway.