MTP3.10 Establishing a nurse-led telephone triage service for head and neck suspected cancer referrals

Abstract The steadily increasing number of head and neck cancer referrals under the NHS Faster Diagnosis Standard (FDS) pathway has resulted in overburdened services and long patient waiting times. To address these challenges, a nurse-led telephone assessment model was introduced to optimise resource allocation, enhance cancer detection rates, and prioritise urgent cases. Over four months, 656 referrals were reviewed, with a triage nurse directing patients to one of three pathways: Telephone Assessment Clinic (TAC), Straight to Test (STT), or face-to-face (F2F) appointments. Amongst the 360 patients assessed via TAC, 84 were classified as high-risk, 259 as low-risk, 14 redirected to appropriate services, and 3 discharged as per patient's request. Of the low-risk and high-risk patients, 2 and 5 were diagnosed with malignancy, respectively. In the STT pathway, triage nurses directly requested diagnostic tests for 78 patients, resulting in 12 discharges without F2F appointments, 38 receiving non-cancer findings requiring follow-up, 15 with suspicious findings who remained on the 2WW pathway, 6 redirected to appropriate services, and 7 who did not attend their scan. 34 inappropriate referrals were identified during triage and redirected to the appropriate clinics. Of the 27 total cancer cases detected, 51.9% met FDS, whereas amongst the 552 benign cases, 88.8% met FDS. This model demonstrated significant improvements in diagnostic accuracy, resource utilisation, and patient outcomes, achieving a 87.2% FDS overall. The findings highlight the potential of nurse-led triage & STT pathways to streamline diagnostic processes, alleviate NHS service pressures, and optimise care for head and neck cancer patients.