Nurses will be at the centre of a government drive to diagnose more cancer patients more quickly, due to be announced by the prime minister tomorrow.
In his speech to the Labour party conference tomorrow, Gordon Brown will pledge to provide all patients with the results of diagnostic tests within one week of visiting their GP or consultant by 2014.
As an interim measure, he will guarantee that within three years the time for the tests will be brought down to two weeks.
The announcement will form part of an initiative to save the lives of up to 10,000 cancer patients each year, which will be led by cancer tsar Mike Richards.
National clinical director for cancer Professor Richards told Nursing Times the pledge would result in “new and additional roles for nurses”, who will play a crucial part in carrying out many of the tests. Examples include endoscopies, flexible sigmoidoscopies and ultrasounds.
The investment in diagnostic services will see “increasing opportunities for nurse practitioners” in this area, Mr Richards said. Funding will be made available to train nurses to perform these roles.
“We already have nurse endoscopists and we need more. There is no reason why these tasks can’t be performed by nurses.
“Nurses can also be trained to deliver ultrasound scans, and there will also be roles for nurses in raising awareness of symptoms.”
The prime minister will announce that some capital funding, which for the last decade has been largely directed towards improving hospital buildings, will in future be spent on the diagnostics equipment needed in GP surgeries, polyclinics and community hospitals to fulfil the pledge. This will include MRI and CT scanners and ultrasound machines.
“The whole aim of this is to be able to diagnose cancer earlier,” Professor Richards said. “Research shows that if we can bring the cancer survival rates up to the best in Europe, we will save around 10,000 lives a year.”
He said the sort of patients that the diagnostics are intended to benefit are those who do not fulfil the criteria for an urgent two-week referral to a specialist, but about whom a doctor has concerns.
Examples included a woman presenting with abdominal pain and loss of appetite, which could be irritable bowel syndrome or could be ovarian cancer, or a patient with rectal bleeding but who was below the age where cancer was common.
“If they had direct access to endoscopy services, it might be 3 to 5 per cent of those do have cancer and we want to pick them up as quickly as possible.”
Mr Brown will say that the diagnostics will initially be targeted at lung, colorectal and ovarian cancers, with a commitment to extend the tests to all cancers within five years.
Buckinghamshire Hospitals NHS Trust’s lead breast cancer nurse Dawn Symonds warned the target could put a lot of pressure on nurses and pathology departments.
“The gold standard in cancer care is triple assessment – clinical examination, ultra sound and pathology. It is also recommended that any results are discussed at a multidisciplinary team meeting,” she said.
“It could be a huge challenge to do all these things safely [within a week], and if patient expectations are raised to this level it will put increasing pressure on specialist nurses,” she added.
Dawn Symonds stressed that the diagnostics would have to be done by specialist nurses, for example those running outreach clinics. “Nurses can be trained how to perform ultrasound scans, but you need to have the knowledge to be able to interpret them,” she said.