Quality standard
Quality statement 3: Suspected cancer pathway referrals
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
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements and clinical protocols ensuring that a suspected cancer pathway is in place for suspected malignant melanoma.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by provider organisations, for example service protocols.
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 covers information on the 2-week wait for suspected skin cancer.
Outcome
a) Time between GP referral for suspected skin cancer and specialist assessment.
Data source: NHS England Cancer waiting times covers information on the 2-week wait for suspected skin cancer.
b) Time from GP referral for suspected skin cancer to first definitive treatment.
Data source: NHS England Cancer waiting times covers information on 31-day waits for first treatment for suspected skin cancer.
What the quality statement means for different audiences
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 and integrated care systems) ensure that services they commission refer people with suspected malignant melanoma using a suspected cancer pathway for an appointment within 2 weeks.
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
Suspected cancer: recognition and referral. NICE guideline NG12 (2015, updated 2021), recommendations 1.7.1 and 1.7.2
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. [NICE's guideline on suspected cancer, terms used in this guideline]