South West Clinical Senate. Colorectal Cancer Commissioning Guidance (Sept 2018)

To what extent are providers in the South West able to deliver the national
commissioning pathways for colorectal cancer patients?
What are the key areas for pathway redesign and provision of service that will
improve the quality of experience & timeliness of treatment for patients across the
region?
Overview
Colorectal cancer is the fourth most prevalent cancer in the UK and the 2nd largest
killer. Achieving world-class cancer outcomes: a strategy for England 2015-20 sets
out ambitions for the earlier diagnosis of all cancers.
The South West Clinical Senate Council met on 27th September 2018 to discuss the
implementation of the whole pathway guidance for colorectal cancer.
The colorectal pathway includes four entry points:
 Via screening for colorectal cancer which includes the faecal occult blood test
and, more recently the recommendations from the National Screening
Committee that Faecal Immunochemical Test (FIT) is introduced by April
2019.
 Through the 2-week referral pathway for suspected cancer
 A routine referral from general practice
 Presentation at the emergency department
Bowel cancer, when diagnosed and treated early has a good prognosis. However,
mortality from bowel cancer in the UK lags behind many of the OECD countries. The
ambition of the national guidance (Clinical Advice for the Commissioning of the
Whole Bowel Cancer Pathway) is to reduce the large unwarranted variation in
diagnosis and treatment and to increase the uptake of screening so as to enable
earlier diagnosis.