Quality statement 3: Suspected cancer pathway referrals

Quality statement

People with suspected malignant melanoma are referred using a suspected cancer pathway for an appointment within 2 weeks.

Rationale

Timely referral to a specialist is important for a quick and accurate diagnosis of skin cancer. The specialist will usually be working as part of the local hospital skin cancer multidisciplinary team and can provide rapid diagnosis, treatment, management and follow‑up for most people with skin cancer. Some squamous cell carcinomas, basal cell carcinomas and less common skin cancers may also need urgent referrals, in line with clinical judgement.

Quality measures

Structure

Evidence of local arrangements and clinical protocols ensuring that a suspected cancer pathway is in place for suspected malignant melanoma.

Data source: Local data collection.

Process

Proportion of confirmed malignant melanomas that were referred using a suspected cancer pathway for an appointment within 2 weeks.

Numerator – number in the denominator that were referred using a suspected cancer pathway for an appointment within 2 weeks.

Denominator – number of confirmed malignant melanomas.

Data source: NHS England Cancer waiting times.

Outcome

a) Time between GP referral for suspected skin cancer and specialist assessment.

Data source : NHS England Cancer waiting times.

b) Time from GP referral for suspected skin cancer to first definitive treatment.

Data source : NHS England Cancer waiting times.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (GP practices and secondary care providers) ensure that systems are in place for people presenting with suspected malignant melanoma to be referred using a suspected cancer pathway for an appointment within 2 weeks.

Healthcare professionals (such as GPs or secondary care clinicians) ensure that they refer people with suspected malignant melanoma using a suspected cancer pathway for an appointment within 2 weeks.

Commissioners (NHS England, clinical commissioning groups) ensure that services they commission refer people with suspected malignant melanoma using a suspected cancer pathway for an appointment within 2 weeks.

What the quality statement means for patients and carers

People who have skin lesions, such as damaged or injured patches of skin or new, large, changing or unusual looking moles, and whose GP thinks it is a type of skin cancer called malignant melanoma, are referred for an appointment to see a specialist within 2 weeks.

Source guidance

Definitions of terms used in this quality statement

Suspected cancer pathway referral

The patient is seen within the national target for cancer referrals. This was 2 weeks at the time of publication of the NICE guideline on suspected cancer: recognition and referral.