Pathway navigators speed access to lung cancer treatment

The UK Lung Cancer Coalition (UKLCC) has published its report, Pathways matter: a review of the implementation of the National Optimal Lung Cancer Pathway (NOLCP).

Lung cancer survival rates in the UK are low relative to comparable countries, and delays in treatment are a contributing factor to this. Around half of patients with lung cancer in the UK are diagnosed at an advanced stage, and a third are treated outside the current 62-day waiting time target. In 2017, the NOLCP was introduced by NHS England to accelerate diagnosis and cut treatment times from 62 to 49 days.

The NOLCP recommends the appointment of a ‘pathway navigator’ to track and reschedule appointments, chase results, and provide a central point of contact for patients and their families. The average cost of a lung cancer pathway navigator ranges from £20,000–25,000 per annum, and the post requires no clinical knowledge. However, securing funding for the role remains ‘challenging’, according to interviews conducted at 17 of the 19 Cancer Alliances for the Pathways matter report.

The appointment of a pathway navigator can more than double the number of patients with lung cancer receiving treatment by day 49. Professor Mick Peake, Chair of the UKLCC’s Clinical Advisory Group, said that ‘the patient pathway navigator has been singled out by our research as one of the most impactful and cost‑effective changes made as part of NOLCP implementation’. The Pathways matter report proposes that economic modelling should be undertaken in future to assess the positive impact of pathway navigators on patient survival.

The report also recommends introducing a central positron emission tomography (PET) scan booking system to ensure timely access to the limited number of PET scanners in the UK. Other recommendations include: direct referral by radiologists of suspicious chest X-rays, availability of X-rays and images prior to diagnostic multidisciplinary team meetings, and reconfiguration of the pathology pathway to expedite urgent samples.

The Pathways matter report can be downloaded from the UKLCC website.