Publish date: 16 April 2019

In 2017, Cheshire and Merseyside Cancer Alliance (CMCA) successfully bid to NHS England for national transformation funding to support the design (where required) and implementation of Optimal Lung and Colorectal Pathways. The aim was to improve patient experience and support delivery of the 28, 31 and 62 day NHS constitutional standards.

As part of this transformation funding, CMCA were in a position to allocate funding to provider trusts to support recruitment of Agenda for Change (AfC) Band 4 Early Diagnosis Support Workers (EDSWs) for Lung, Colorectal and Vague Symptoms Optimal Pathway projects. Requiring an NVQ level 3 health qualification, the role aimed to support local multidisciplinary teams (MDTs) and lead to more efficient patient throughput along optimal pathways, from referral receipt to diagnosis as well as supporting better patient experience of the diagnostic journey including:

  • Undertaking less complex keyworker activity, freeing up Clinical Nurse Specialist (CNS) time, allowing CNSs to potentially undertake clinical work such as endoscopy, biopsies and administering treatments (skill mix benefit).
  • Direct liaison with patients on optimal pathways to facilitate planned diagnosis (e.g. ordering wheelchairs/equipment; coordinating appointments with patients; organising referrals).
  • Providing advice and support within outpatient clinics to free up consultant/nurse led clinic time.

This has shown:

  • In 11 months, EDSWs recorded support for over 6,600 patients, making over 12,800 contacts
  • Over half of contacts were with the patients themselves or administrative staff, often about appointments or diagnostic tests.
  • Qualitative patient feedback highlights the value of EDSWs in reducing anxiety and providing reassurance, navigating complex NHS systems for unwell patients and being a friendly, non-clinical point of contact for queries.
  • Case study evidence shows patients supported by EDSW input experienced shorter waiting times.