Non-Site Specific (NSS) Cancer pathway

What is NSS?

The NSS pathway will facilitate referrals for patients with symptoms that do not fit discretely into a single urgent cancer referral pathway as defined by NG12, but who are at risk of having cancer. These patients often experience disjointed management and are at risk of late diagnosis.

Queen Victoria Hospital NHS Foundation Trust (QVH) are currently establishing a centralised NSS service to be delivered across Sussex and East Surrey. The Community Diagnostic Centre (CDC) at QVH will act as an administrative hub for this NSS pathway.

Referrals will be received from GPs across Sussex Integrated Care Board (ICB), and the population of Surrey and Sussex Healthcare NHS Trust (SaSH). Once the referral is received, the NSS Team will then coordinate patient investigations and/or diagnostic scans, within the CDCs across Sussex and East Surrey.

The aim of the NSS pathway is to expedite onward referral of patients with possible cancer and to reassure and discharge patients with no findings or benign disease. NSS pathways are classed as USC (Urgent Suspected Cancer) pathways, and consequently reportable under cancer waiting time’s performance standards. Establishing this pathway will support the national objective of 100% NSS pathway population coverage by 2024/25.

Please note, while the initial roll out of services will be restricted to referrals from GPs local to QVH, once the model is successful a sequential roll out across the designated area covered will begin.

Why is the NSS Cancer Pathway needed?

  • Patients with vague symptoms often bounce around the system and are at risk of late diagnosis.
  • Around 7% of patients on an NSS pathway will get a cancer diagnosis
  • Only 5-10% cancers detected through Urgent Suspected Cancer (USC) pathways1
  • Half of all cancer patients never have a red flag symptom2
  • 67% of patients with non-specific symptoms are diagnosed at a late stage (compared to 45% site specific)2
  • NSS pathways also identify serious (non-cancer) conditions that need management in primary or secondary care
  • Sussex does not have an NSS pathway, it is the only region in the country not to have one
  • 1N Jensen Br J Cancer, 2014; 2National Cancer Diagnosis Audit 2018

If you would like to get involved in the development of this pathway across Sussex and East Surrey, or for any questions about the NSS process or patient eligibility for referral, please contact the NSS Team, Queen Victoria NHS Foundation Trust via mail:

qvh.nss-surreyandsussex@nhs.net

 Lead Consultant: Saoirse Dolly

Clinical Nurse Specialist: Lisa Smith

Pathway Coordinator: Reena Rajan

Project & Delivery Manager: Charlotte