653 An Audit of the Cancer Diagnosis Timeline Utilising a Telephone Triage System in the Two Week Wait (2WW) Head & Neck (H&N) ENT Clinic

Aim There is increasing focus on re-designing 2WW clinic pathways to improve their efficiency – aiming to diagnose cancer within 28 days and deliver treatment within 62 days. Our audit assessed if implementing a telephone triage system via a H&N Clinical Nurse Specialist could achieve this in the H&N 2WW Clinics. Method Following local audit approval, H&N 2WW referrals to the ENT department were reviewed – 2 months data prior to telephone triaging, and 2 months data utilising telephone triage as an adjunct to clinic. Patient demographics, primary referral symptom, diagnosis, timeline of consultations, and treatment were recorded using clinic letters, electronic records, and MDT outcomes. Results 273 patients were analysed; identification of 12 cancer patients from before telephone triage dataset and 14 cancer patients from the after dataset (non-H&N cancers, patients from other hospitals and those under maxillofacial were excluded). Tere was no significant difference in mean time to initial consultation (p=0.1875), mean time to diagnosis (p=0.0620), or mean time till first definitive treatment (p=0.7747). Analysing telephone triage consults alone (n=7), the mean time to initial consultation was reduced (p=0.0198), but the mean time to diagnosis (p=0.3130) and first treatment (p=0.7542) were similar. Conclusions This audit demonstrates objective evidence that telephone triaging does not delay cancer clinics or treatment from the current standard. If patients referred to 2WW clinic are initially telephone triaged, there is potential to significantly reduce the time to initial contact and there may be greater patient acceptability in terms of patient transport, time taken off work, etc.