Ear, Nose & Throat challenges

Head and neck cancer affects about 12,400 people each year in England, making it the eighth most common form of cancer. 1,2

To ensure timely diagnosis, the Faster Diagnosis Standard (FDS) was introduced in 2021/2022, which aims to diagnose cancer within 28 days from the point of suspicion. The NHS in England aims to confirm the diagnosis for 75% of patients with suspected cancer within 28 days from the point of suspicion, and this target will be increased to 80% by 2025/26.

However, there is a significant variation in the diagnostic performance between NHS providers in England. Between January and March 2023, of the 114 providers that saw 20 or more patients with suspected head and neck cancer, only 54% met the 75% target, with some providers performing as low as 45%. 3

Delayed diagnosis can further delay treatment, with only 61% of patients beginning cancer treatment within 62 days of referral between 2018 and 2020. 2

Outpatient biopsies, instead of general anaesthesia biopsies, could reduce diagnosis and treatment initiation times by over two weeks, significantly improving patient outcomes.4

Reduced time to diagnose and treat

It could reduce the time to diagnosis and treatment by bypassing theatre scheduling delays inherent to inpatient procedures.

Increased theatre capacity

It could release theatre capacity by freeing up slots previously allocated for these procedures in the operating theatre.

Reduced risks for patients

It could reduce patient risks by avoiding the potential complications associated with general anesthesia and inpatient procedures.

Reduced costs

It could reduce costs by eliminating the need for theatre time, inpatient beds, and extended hospital resources.

Improved patient experience

It could improve the patient experience by minimising hospital visits and reducing the anxiety associated with invasive, inpatient procedures.

Healthcare Conversations

Joshua Hicks, Health Economics and Market Access Manager, discusses the importance of Pathway Transformation within the discipline of ENT

You might need to purchase new equipment to perform outpatient-based biopsies

This includes the ENF-VT3 rhino-laryngo video scope, which enables transnasal endoscopy and pharynx treatments.

The CV-170 outpatient surgical imaging platform enables cost-effective access to high-definition television and narrow-band imaging for endoscopic diagnosis in ENT.

Details

1. NHS Choices (2019). Head and neck cancer. [online] NHS. Available at: https://www.nhs.uk/conditions/head-and-neck-cancer/. Information from the NHS website as of 09/08/23.

2. National Health Service (2023) Faster diagnostic pathways. Implementing a timed head and neck cancer diagnostic pathway. Guidance for local health and care systems. Available at: https://www.england.nhs.uk/wp-content/uploads/2018/04/B1130-head-and-neck-cancer-implementing-a-timed-diagnostic-pathway.pdf (Accessed:7 June. 2023).

3. www.england.nhs.uk. (n.d.). Statistics» Provider – based Cancer Waiting Times for Q4 2022/23 Final. [online] Available at: https://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/quarterly-prov-cwt/2022-23-quarterly-provider-based-cancer-waiting-times-statistics/provider-based-cancer-waiting-times-for-q4-2022-23-final/ [Accessed 14 Aug. 2023].

4. Health Technology Wales. (n.d.). Outpatient laryngeal biopsy. [online] Available at: https://healthtechnology.wales/reports-guidance/outpatient-laryngeal-biopsy[Accessed 7 Jun. 2023].

5. Reference will be added once NHS Supply Chain publishes the case study on its website (expected May 2025).