Innovative nurse-led triage and biopsy team helps enhance UHDB's prostate cancer diagnostic care
A dedicated team of nurses at UHDB have been working hard to ensure that patients who are referred to us with suspected prostate cancer are told they are cancer-free, or if they require the start of their cancer treatment, as soon as possible.
Within our Oncology (Urology) departments at Royal Derby Hospital and Queen's Hospital Burton, the Prostate Cancer Triage Team and Nurse-Led Biopsy Service was set up in January 2023 and August 2023 respectively in order to bring the diagnostic journey for patients referred to us with suspected prostate cancer into a single service.
Since the fully combined service's implementation in August 2023, there has been a remarkable impact on the care provided within our prostate cancer diagnosis services. Over 1,000 patients have been referred to the triage team, and in that time, over 500 biopsies have been performed, with the average time from referral to biopsy being performed has dramatically reduced from over 80 days in January 2023, to just 23 days - representing a more than 70% decrease in waiting times, and far exceeding the national 28 Day Diagnostic Target for cancer patients.
As well as enhancing the efficiency in which we deliver these services, the implementation of the new team has helped to improve the patient experience for many of our service users. The team act as a single point of contact for these patients, helping to navigate different clinical departments involved in their care, at what can be a very challenging time. This allows them to closely monitor the investigations of their patients, and provide a simple yet efficient diagnostic journey - with nursing colleagues within the team 'up-skilled' to bring triage and biopsy within their range of expertise, and therefore supporting us to provide a diagnosis as soon as possible.
Lucy Tuckwood, an Advanced Clinical Practitioner who leads the triage team at Royal Derby Hospital, said that following the Covid-19 pandemic, there was a 'backlog' of cancer referrals and patients waiting for prostate biopsies. This challenge led to the establishment of the service, with Lucy explaining that prior to its implementation, "the road to getting a biopsy was more convoluted" than either we, or our patients would have liked.
Continuing, Lucy said: "We knew there had to be a more efficient way of managing this and working to drive down the backlog - so the nurse-led service was implemented in order to streamline that diagnostic pathway, speeding up the process and alleviating the anxiety associated with prolonged wait times for results.
"This leveraged the expertise of existing advanced and specialist nursing within our organisation, as well as equipping our team with new skills to deliver much of the process through a single place."
Thanks to the new service, the referred patients who are otherwise fit and well can go straight for an MRI after being referred, after initial checks to ensure it is safe for them to do so, bypassing the need for multiple consultant appointments.
The team then tracks these results diligently, and gets the patient seen by a consultant for further investigation as soon as possible, if necessary. While that continues, the team 'pre-plan' for a biopsy as soon as possible - often just a few days - to make sure they can provide a conclusive diagnosis at the earliest possible stage.
Reflecting on the feedback received so far, Lucy said there was "no question" that our patients appreciate the efficiency of the new system. She continued:
"Knowing they'll be looked after quickly, and that they have our team as a consistent point of contact throughout their journey has been crucial to making their experience as positive as we can. Providing clarity and support, and building a strong rapport, plays an enormous role in reducing the stress often associated with cancer investigations."
The service has also been instrumental in identifying patients who do not need to be on the cancer pathway at an early stage. This ensures that those requiring further investigation receive prompt attention, while others can be reassured and guided appropriately. It also benefits our colleagues in enhancing their skills, aligning with our organisational commitment to continuous improvement and staff development.
Saying the team will not "rest on their laurels", Lucy said that the team's aim is to further reduce the referral to biopsy time even more:
"We are committed to our ultimate goal of getting patients the tests they need as quickly and efficiently as possible - and to ensure all patients feel confident in raising concerns, and knowing they are being looked after every step of the way."
The combined Prostate Cancer Triage Team and Nurse-Led Biopsy Service continues to evolve - a testament to our colleagues dedication to operational excellence and the best possible care. This innovative approach not only enhances the patient experience, but also exemplifies our vision of delivering outstanding health services through continuous improvement, creative forward-thinking approaches, and collaboration.