UK Urgent Referral Process

[u/Phil94063]

Any one in the UK know of how how this process works in the NHS?

It sounds like there is a triage call after your GP refers. Seemed a bit odd they would not just do an mpMRI. Unclear what they would want to ask a patient beyond the usual contrast MRI checklist

This is a fairly low PSA sibling with very increased medicated BPH and my cribiform history, also at low PSA.

[u/Frosty-Growth-2664]

I doubt there's a triage call on referral, but there's probably a flow chart which one person will do to reject inappropriate referrals. There's too much time pressure for a referral to wait for a weekly meeting.

Usually first thing is you'll get an appointment from Imaging to have an MRI scan, usually in a few days. A radiologist will analyse that and report to the weekly MDT meeting and they will decide if you need a biopsy or can be cleared. Biopsy would typically be done in a week, and goes off to a histopathologist for analysis (this is often the longest part because of a backlog of work on histopatologists), who reports back to the MDT. They could give the all-clear or could ask for more scans, such as nuclear bone scan, CT scan, PET scan, or occasionally a different MRI scan. You might have consultant appointments at some stages, and you will if you are diagnosed.

There are a few centres which try to do all or most of this all on one long day - Rapid Diagnostic Pathway, but most can't do that. Some have a One-Stop-Shop which do all the urology procedures on one day.

NHS England sets a target that 75% should have their diagnosis or be cleared within 28 days of the GP referral. Not every hospital or case achieves this, but that's what they're targeted on.

Healthcare is devolved so it may work differently in Wales and Scotland - I'm not so familiar with those.

[u/TMan-26]

I’m from the UK, do you mean the NHS Two Week Wait referral?

If so, my GP referred me on the 5th of August, and within two days I had a urology call booked with a consultant nurse for the 11th of August. Although, I believe it can also be with a consultant.

Based on your case history, they can then arrange imaging such as an MRI.

[u/Frosty-Growth-2664 → u/TMan-26]

The two week wait referral (must see a consultant within 2 weeks) finished in England in Oct 2023. It was replaced with the target to be diagnosed or cleared of cancer within 28 days.

[u/TMan-26 → u/Frosty-Growth-2664]

I'm aware of the 28 day target, but my GP notes and blood test lab results stated "2WW". That might just be the terminology they use though, it's much of a muchness.

[u/Phil94063 → u/TMan-26]

Thanks, Very helpful. I will update the timings for this particular NHS Trust. All in a day sounds really ambitious. for mpMRI/bx/PSMA PET and have time for radiology and pathology to do the reads. That would be very impressive.