Fast-tracked and optimised: The impact of a one-stop lung cancer clinic on patient outcomes

Patients with resectable early-stage lung cancer but who are at higher risk from thoracic surgery often face complex pathways to make a treatment decision resulting in negative outcomes. The GM One-stop lung cancer clinic (GM-OSLCC) provides a multi-disciplinary service of thoracic surgeons, anaesthetists, clinical oncologists, physicians, specialist nurses alongside prehabilitation, tobacco dependency and frailty specialists to support treatment decisions in a single clinic visit. Outcomes were compared between a pre-implementation cohort (n=94) with a post implementation cohort (n=114). The median time from referral to decision to treat reduced from 20 days (IQR:13-32) to 4 days (IQR:3-8, p≤0.001). The GM-OSLCC increased the uptake of: prehabilitation (p=0.036), frailty interventions (p<0.001), tobacco dependency treatment (p<0.001) and malnutrition interventions (p<0.001). The average number of outpatient clinic visits reduced from 2.4 to 1 and 12-month mortality reduced from 12.8% to 3.5% (p=0.013). This one-stop model of care has delivered significant pathway improvements and increased the uptake of optimisation interventions, leading to significantly reduced 12-month mortality.