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
Case Study: Manchester University NHS Foundation Trust
Enabled by Olympus’ ENF-VT3 Rhinolaryngoscope, the outpatient clinic improved diagnostic access and delivered average savings of £2,260 per case — earning recognition as a value-based procurement project.
Manchester University NHS Foundation Trust piloted a local anaesthetic outpatient biopsy clinic between April and October 2023 to address delays in biopsy access for head and neck cancer patients. Traditionally, biopsies are performed under general anaesthetic in theatres, leading to bottlenecks due to resource constraints. The pilot tested whether local anaesthetic-based biopsies could improve access, reduce costs, and provide accurate samples for diagnosis.
The project is now formally recognised as a value-based procurement project by NHS Supply Chain.
It aligns with the NHS Faster Diagnosis Standard (28-day target), aims to reduce theatre reliance, and supports scalable outpatient cancer diagnostics.2
Read the full case study here to see the full results
This is now part of a value-based procurement project with NHS Supply Chain read more
Overall
Although the pilot was completed in late 2023, its outcomes are now being used to inform a value-based procurement project with NHS Supply Chain — supporting the potential rollout of this model across other NHS trusts. The initiative aligns with wider efforts to improve diagnostic access, reduce costs, and meet national cancer pathway targets.
Encouraged by these results, Manchester University NHS Foundation Trust plans to expand the service and contribute findings to national best practice discussions, enhancing access to timely diagnostics alongside biopsies under general anaesthesia.[1].
Download the full case study nowHow to achieve outpatient biopsy:
In collaboration with Gill Martin and Jonathan Hughes from Royal Free London NHS Foundation Trust, we have developed a step-by-step guide for those considering the implementation of pharyngolaryngeal biopsy under local anaesthesia for people with suspected head and neck cancer in the outpatient setting.
The guide integrates the use of the Olympus ENF-VT3 a video Rhinolaryngoscope. The ENF-VT3 is a channelled scope and is compatible with a wide range of biopsy forceps used to obtain tissue sample’s.
This collaboration underscores Olympus's commitment to advancing medical technology and patient care.
Download How-To GuideYou 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.
DetailsIt’s Time to Make the MOVE
MOVE from the OR to the outpatient setting and discover an alternative way to perform ENT procedures. Recommended by multiple professional standards agencies, outpatient ENT procedures can be a viable alternative to conventional OR-based techniques.
Learn more >1. NHS Choices (2019). Head and neck cancer. [online] NHS. Available at: hhttps://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).