Quality statement 1: Diagnostic pathways

Quality statement

Sarcoma advisory groups and sarcoma multidisciplinary teams (MDTs) have pathways for referral and diagnosis in place for people with suspected sarcoma.

Rationale

Because malignant sarcomas are rare, they are often diagnosed late, resulting in poorer patient outcomes. To improve diagnosis, people with suspected sarcoma need to be recognised early and quickly referred to services that can confirm the diagnosis. However, because sarcomas often can't be reliably distinguished from benign conditions using clinical judgement, a large number of benign cases will also be referred to diagnostic services, creating a large diagnostic workload. To prevent specialist sarcoma services from becoming overwhelmed by referrals to confirm diagnosis, diagnostic pathways will need to be developed by sarcoma advisory groups in conjunction with sarcoma MDTs. These pathways will need to be agreed with the services providing the referrals, including GPs, general diagnostic imaging services and other secondary care providers.

Quality measures

Structure

a) Evidence that sarcoma advisory groups and sarcoma MDTs have pathways for referral and diagnosis in place for people with suspected sarcoma.

Data source: Local data collection.

b) Evidence of local arrangements to agree and communicate diagnostic pathways with primary and secondary care providers.

Data source: Local data collection.

Outcome

Stage of sarcoma at diagnosis.

Data source: Local data collection.

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

Sarcoma advisory groups and sarcoma MDTs establish and implement pathways for referral and diagnosis for people with suspected sarcoma, ensuring that primary and secondary care providers are involved in their design.

Primary and secondary service providers (hospitals, sarcoma specialist centres, diagnostic clinics, GPs) follow pathways for referral and diagnosis for people with suspected sarcoma that have been agreed by sarcoma advisory groups and sarcoma MDTs. They should also ensure information about these pathways is easily accessible to staff.

Healthcare professionals ensure that they follow pathways for referral and diagnosis for people with suspected sarcoma that have been agreed by sarcoma advisory groups and sarcoma MDTs.

Commissioners (clinical commissioning groups and NHS England) ensure that all sarcoma advisory groups and sarcoma MDTs work with primary and secondary care providers to establish and implement pathways for referral and diagnosis for people with suspected sarcoma.

What the quality statement means for patients, service users and carers

People with symptoms that suggest sarcoma (a rare type of cancer that develops in a bone or in soft tissue such as muscle or fat) are referred and have investigations carried out by healthcare professionals who follow advice on diagnosing sarcoma from specialists in sarcoma.

Source guidance

  • Sarcoma (2006) NICE cancer service guidance, Section 3: Improving diagnosis of bone and extremity soft tissue sarcoma (pageĀ 37)

Definitions of terms used in this quality statement

Suspected sarcoma

The NICE guideline suspected cancer: recognition and referral includes recommendations for referral for suspected sarcoma.