Reviewed on : 9 Feb 2024

Reviewed by : Michelle Park

Expires : 9 Feb 2026

Non-Specific Symptoms Pathway for a Possible Cancer Diagnosis

South Warwickshire University NHS Foundation Trust (SWFT) is pleased to announce the introduction of a new Non-specific Symptoms Pathway, designed for those patients with worrying non-site-specific symptoms for whom the GP feels cancer is a potential diagnosis

This service is for South Warwickshire GPs only

About the Service

The Clinical Lead for the service is Dr Istvan Mazak (Consultant leading NSS pathway), who will be supported by a team, including ACP’s, Radiology, Clinical Nurse Specialists, and other specialist colleagues

This pathway aims to:

• Provide a single referral point, avoiding multiple GP visits and secondary care referrals for those with non-site-specific signs and symptoms for whom the GP feels cancer is a possible diagnosis
• Provide timely re-assurance when there is a clear ‘no cancer’ diagnosis & refer to the appropriate team or back to the referring GP
• Where a cancer diagnosis is made facilitate timely referral to the appropriate specialist cancer team, for ongoing management and treatment
• Provide a positive patient experience, faster diagnosis and improved outcomes in line with cancer waiting time standards and the milestones set out in the NHS long term plan
• Meet standards of a suspected cancer pathway including details of investigations and any on-going actions or treatment required
• Provide feedback and information to Primary Care relating to their referred patient

Inclusion Criteria

Age 40+ AND unexplained weight loss

Age 40+ AND constitutional symptoms (+4 weeks)

• Decreased appetite
• Nausea and/or vomiting
• Bloating
• Non-specific abdominal pain
• Fatigue
• Progressive / Unexplained pain / Other pain

Any Age (ADULTS 16+)

• Anaemia (Hb<100g/L) (not iron deficient, not bleeding)
• Unexplained night sweats
• Hepatomegaly (significant with clinical correlation)
• Splenomegaly (>18cm)
• Unprovoked DVT with signs and symptoms suggesting underlying cancer
• Abnormal imaging suggestive of metastatic disease with unknown primary
• Primary Care Clinicians Gut Instinct

Exclusion Criteria

Referral

Refer using the established 2WW referral route using the attached form (see right)

Record your referral in the EMIS clinical record using the Snomed code : 3082491000000112 FAST TRACK REFERRAL FOR SUSPECTED CANCER DUE TO NON -SITE-SPECIFIC SYMPTOMS (PROCEDURE)

Remember to save the file to downloads or desktop on your PC and import from EMIS to view the form

The referral form will also be available on Arden

Form previewed below:

Contact

If you have any further questions about the service, please feel free to contact:

• Michelle Park – Coventry & Warwickshire ICB – System Cancer Lead (Michelle.Park4@nhs.net)
• Nicola Mills – General Manager Elective Delivery & Performance (Nicola.mills@swft.nhs.uk)
• Clinical team supporting the NSS pathway (mdcu@swft.nhs.uk)