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Improving a suspected cancer pathway at Aneurin Bevan University Health Board

Improvement work to shorten the diagnostic and treatment pathway for colorectal cancers is showing early promise at Aneurin Bevan University Health Board (UHB).

The health board’s pathology and endoscopy services have been testing new approaches to classifying, organising, and managing pathology samples to improve the processing speed and capacity for urgent suspected cancer samples, while coordination across multiple sites to reduce referral time for endoscopy is highlighting that there are real opportunities for meaningful change.

The health board is delivering the improvement work with the support of Improvement Cymru, Wales Cancer Network and learning from Toyota Lean Management Centre in relation to the Suspected Cancer Pathway. The organisations are supporting multidisciplinary cancer teams (MDTs) across NHS Wales to reduce the time between cancer being suspected and a diagnosis being made and identify learning that can benefit all cancer services in Wales.

As part of the work, participating cancer MDTs in Wales are receiving support to develop their change ideas by experts and colleagues from Improvement Cymru and benefitting from transferrable learning, training and coaching from vehicle manufacturer, Toyota, based on its world-renowned Toyota Production System.

Toyota representatives have visited the Aneurin Bevan UHB colorectal cancer MDT to understand their suspected cancer pathway and provide training in the Toyota Production System methodologies. The Aneurin Bevan UHB team has also received intensive training at the Toyota Lean Management Centre in Deeside, which has been funded by the Wales Cancer Network.

Mr K Swarnkar, Lead Clinician Colorectal MDT, Aneurin Bevan University Health Board, said: “Training with the Toyota team has helped us to gain insight into inefficiencies in the ‘processes and pathways’ that impact on speed of diagnosis and subsequent treatment planning. Given the multi-speciality nature of the pathway, it has been particularly helpful to identify the problems, bring change and collaborate in this process. This includes collaborative work with primary care services.

“This work has facilitated novel approaches to pathways improvement and developing practical action plans.”

The Aneurin Bevan UHB colorectal cancer team is one of three MDTs across NHS Wales that formed an initial cohort of teams receiving this support. A second cohort has recently commenced, bringing the total number of participating MDTs to seven.  

Ross Nowell, Improvement Manager at Improvement Cymru, said: “The team at Aneurin Bevan UHB have been really engaged and made positive steps, and we’re looking forward to working with them to maintain that momentum and continue to sustain the impact of their initial learning.

“We’re pleased to be working with the Wales Cancer Network and Toyota to support health boards across Wales to deliver this important work, which we hope will reduce the period of time that people throughout Wales need to wait between suspicion of cancer and a diagnosis being made.”

Dr Jeff Turner, Suspected Cancer Pathway Clinical Lead for the Wales Cancer Network, NHS Executive, said: “It is fantastic to see the positive benefits this collaborative work is already having in improving the pathway for people referred with suspected cancer, with the approach and initial learning showcased at the recent national cancer recovery and improvement intervention lower GI pathway workshop.”

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