Project Overview
An NHS Foundation Trust operating a Rapid Diagnostic Centre (RDC) — one of NHS England's cancer diagnostic hub...
Technology Stack
Compliance & Standards
The Challenge
An NHS Foundation Trust operating a Rapid Diagnostic Centre (RDC) — one of NHS England's cancer diagnostic hubs — needed a digital platform to manage the RDC pathway (2-week wait cancer referrals, diagnostic investigation coordination, multi-disciplinary team MDT tracking, and outcome recording). DTAC all 5 domains, DCB0129 (2WW cancer pathway is highest clinical safety priority), NHS e-Referral Service FHIR R4, NHS Spine PDS, WCAG 2.1 AA, and UK GDPR Article 9 were mandatory. Budget: £85,000.
Our Approach
Week Wait Cancer Pathway Management
Cancer 62-day standard: GP refers via NHS eRS (2WW referral) → RDC receives referral → investigative workup (CT, MRI, blood tests, scope) → MDT meeting → diagnosis outcome and treatment planning — all within 62 days of referral.
Platform
pathway timeline tracking per patient (days elapsed, investigations completed, outstanding), breach risk alert at 45 days (17 days remaining to complete pathway), and automatic escalation to RDC coordinator if investigation results overdue.
Investigation workflow
investigation requested (radiology request, endoscopy booking, blood test order) → booked → performed → results received → results reviewed by RDC consultant.
FHIR R4 DiagnosticReport
investigation results integrated via NHS FHIR R4 (radiology PACS — DICOMweb WADO-RS, pathology LIS — HL7 v2 ORU).
Outstanding investigation dashboard
RDC coordinator sees all overdue investigations across all active 2WW patients.
MDT Meeting Digital Workflow
NHS MDT (Multi-Disciplinary Team): weekly meeting where all cancer cases discussed — consultant, specialist nurse, radiologist, pathologist.
Digital MDT list
cases auto-populated from 2WW pathway, investigation results displayed (PACS viewer integration), and MDT outcome recorded (treatment recommendation, staging).
MDT minute automation
structured outcome data → automated MDT minute generated in NICE-compliant format, distributed to GP (via NHS Spine) and stored in electronic patient record.
Highest hazard
patient falls off cancer pathway (referral not actioned, investigation result not reviewed).
Mitigation
- automated chase alerts (investigation result overdue >
- 5 working days → RDC coordinator alert + trust escalation), daily pathway dashboard review required (clinician sign-off that dashboard reviewed), and audit trail of all pathway events.
CSO
consultant oncologist.
Hazard log
14 hazards identified, all mitigated to acceptable risk.
The Results
DTAC approved all 5 domains.
Platform live at 16 weeks, £78,000 — under budget. 62-day standard compliance: 92% (trust target: 85%) — 7 percentage points above target.
Pathway breach rate: 4.2% → 2.8% reduction (breaches are serious patient harm indicators).
MDT minute completion: 100% same-day automated (previously 3–5 day delay).
Investigation result review time: 2.4 days → 6.8 hours.
NHS England RDC programme: trust selected as exemplar for digital pathway management.
“92% 62-day standard compliance versus our 85% target. In cancer services, 7 percentage points is not a statistic — it is real patients receiving diagnosis and treatment on time. Pathway breach 4.2% to 2.8%. MDT minutes same-day automated versus 3–5 days. NHS England selected us as an exemplar based on the platform's impact." — Clinical Director of Cancer Services, NHS Foundation Trust (name withheld)”
Project Details
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