Abstract
Introduction: The Two Week Waiting Time (2wwt) Standard, which requires that patients with suspected cancer referred by general practitioners should be seen within 2 weeks, was introduced in 2000. We reviewed the performance of this standard with regards to proportion of patients seen and tumour detection rates.
Methods and Results: We reviewed all the referrals sent as “two week waiters” from January 2004 to December 2005, to our bone and soft tissue sarcoma service. These referrals were evaluated for
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Whether or not the referral met established referral guidelines for bone and soft tissue tumours
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The proportion of patients seen within two weeks
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The proportion of patients referred under the guidelines that had malignant tumours.
This was compared with the total number of referrals to the unit and their tumour detection rates.
A total of 40 patients were referred as “two week waiters” in the given time period. They were seen on an average of 8 days following the referral. Of the 40 patients, four patients had soft tissue metastasis from a primary tumour elsewhere, and six had primary malignant soft tissue tumours. 12 had a benign bone/ soft tissue tumour. 18 (45%) patients had a non neoplastic pathology (6 Muscle tear/ herniation; 4 ganglion/bursa; 2 lumps that disappeared)
During the same period a total of 515 patients were referred by other routes.
Conclusion: Only 10 of 40 patients referred under the 2-week rule had malignant tumours. The majority of referrals to our service do not fall under this rule. Significant numbers of referral under the 2wwt standard are not in line with the referral guidelines. It is our impression that the 2-week rule, whilst highlighting the need of these patients to be seen urgently may distort clinical priorities and disadvantage patients referred from other sources.
The abstracts were prepared by Mrs Leslie O’Leary. Correspondence should be addressed to her at British Orthopaedic Association, 35–43 Lincoln’s Inn Fields, London WC2A 3PE or at l.oleary@boa.ac.uk
