The hospital are struggling with 2WW referrals in some specialties and we have therefore decided that 2WW forms should be updated to have this message on them:
Referrers: If your patient does not meet any of the NICE defined 2WW criteria please liaise (by phone or Advice and Guidance) with a specialist or send them in as an urgent referral. Please do not annotate 2WW forms with your own criteria.
The criteria are chosen regionally by specialists and GPs to help optimise the early diagnosis of cancer. Varying the criteria risks overwhelming clinics and preventing patients who are more likely to have cancer being seen within two weeks.
The RSS staff have been asked not to accept annotated 2WW forms and to ask referrers to follow this guidance.
All referrals for suspected cancer should now be made via the RSS using the new forms below. 2WW referrals should not be sent via fax.
We have created a form for each cancer site for use by all practices in Vale of York CCG. This CCG based form should be used for all referrals, regardless of where the patient chooses to be referred to. Please see this short video which is an introduction to the new process.
3 December 2019 - Updated 2WW Uppder GI forms
6 November 2019 - Updated 2WW Urology forms
Further to our recent email, the 2WW Urology template has been updated.
14 July 2016 - Updated 2WW templates and information
Further to our recent email, the Upper GI template has been updated to correct a formatting issue relating to some of the referral criteria.
We found that the drop down options identifying the site of breast lump was not working, so this has been corrected, and the template updated.
There are some suspected cancers which do not have a referral form. Details on how to refer these cases is provided below.
Cancer of Unknown Primary (MUO)
Suspected Brain / CNS Cancer Guidance
There is no 2WW Brain/ CNS Cancer Service in York. The nearest service providers are Leeds Teaching Hospitals NHS Trust (0113 2432 799) or Hull and East Yorkshire Hospitals NHS Trusts (01482 875 875).
1. For patients with the following symptoms:
Subacute, progressive focal neurological deficit
Unexplained cognitive impairment or behavioural disturbances or changes in personality
Phone the on-call duty radiologist to consider an urgent direct access MRI scan of the brain (to be performed within 2 weeks), or CT scan if MRI is contraindicated.
2. For patients with the following symptoms:
New onset seizure(s)
- Headache (recent onset) with features of raised intracranial pressure (including vomiting, drowsiness, loss of consciousness, change of personality or memory)
Consider acute admission for investigations
3. For patients where imaging has shown the following:
Abnormal MRI/CT showing suspected tumour of brain or CNS
Phone the on-call neurosurgical registrar on the same day of receipt of result
The nearest service providers are Leeds Teaching Hospitals NHS Trust (0113 2432 799) or Hull and East Yorkshire Hospitals NHS Trusts (01482 875 875).
Maxillofacial (Head and Neck)
Malignancy of Lymph Node
Immediately contact the Paediatric Team on call if you suspect that a child has cancer. Click here for NICE guidance for common childhood cancers
Suspected Sarcoma-soft tissue
Ultrasound or MRI suggests soft tissue sarcoma- these will automatically be referred by the Radiology Dept to the Soft Tissue Sarcoma MDT in Leeds. Click here for further information.
X-ray or other imaging suggests bone sarcoma. These patients will automatically be referred by the Radiology Dept to the Bone Sarcoma MDT in Birmingham. Click here for further information