Delivering care through collaboration

Cancer performance and early diagnosis programmes

The Cancer Performance and Early Diagnosis Programmes work collaboratively with academics, wider UK nations, senior leaders, patient representatives, third sector, NHS Scotland’s clinical community and more to improve outcomes for cancer patients. We achieve this, by striving to increase early detection rates of cancer, improving waiting times and enhancing patient experience. The work-streams are driven by Scottish Government cancer policy and can be broadly categorised into the following areas:

  • Cancer Waiting Times CWT) performance
  • Early cancer diagnosis
  • ‘Once for Scotland’ optimal cancer pathways
  • Diagnostic capacity
  • Data to drive improvements in outcomes

 Cancer Waiting Times Performance

Throughout the Covid-19 pandemic cancer has remained a priority. With urgent cancer care continuing, and the 31-day decision-to-treat to first treatment standard being maintained, as we work to overcome any challenges in the 62-day Urgent Suspicion of Cancer (USC) referral to first treatment standard.

Based on the NHS Lanarkshire model, the Framework for Effective Cancer Management was developed in 2018. This adopts a ‘once for Scotland’ approach to performance and improvement to incorporate the new ways of managing cancer pathways and services across NHSScotland that have emerged as a result of Covid-19. A refreshed framework will be published in 2021, with bespoke support provided to NHS Boards, to ensure this is fully embedded.

 Early Cancer Diagnosis

More information on early diagnosis can be found at: https://www.getcheckedearly.org/ 


The Scottish Government’s £43 million Detect Cancer Early (DCE) Programme was launched in 2012 with the aim to increase the proportion of bowel, breast and lung cancers detected at stage one and reduce health inequalities. The DCE Programme is led by the Early Diagnosis Team in the CfSD with work streams focused on:

  • Policy driven behaviour change campaigns, targeting adults aged 40+ from areas of deprivation. These will be delivered in partnership with the Scottish Government’s Marketing Team. Watch the new DCE lung cancer TV advert here.
  • Partnership with Cancer Research UK’s Clinical Engagement Team to deliver regional and local primary and community pharmacy education sessions on lung cancer best practice and latest clinical guidance.
  • The full Scottish Referral Guidelines for Suspected Cancer, published January 2019, can be found by clicking the following link: Home (scot.nhs.uk)
  • Developing clinical guidance in response to the pandemic, to support effective referral processes i.e. management of urgent suspicion of lung cancer referrals during COVID-19; guidance on the use of faecal immunochemical testing (FIT) in the prioritisation of patients with colorectal symptoms. (More guidance on COVID-19 can be found at the following link: Coronavirus (COVID-19): clinical guidance - gov.scot (www.gov.scot)
  • Exploring the emerging role for pharmacy to help identify and expedite those at higher risk of cancer, with support from key stakeholders such as Community Pharmacy Scotland.
  • Development of an early diagnosis hub for health professionals: more information coming soon.


 'Once for Scotland' optimal cancer pathways

Diagnosing cancer earlier will improve both patient experience and outcomes, ensuring Cancer Waiting Time (CWT) standards are achieved.

National optimal cancer pathways will be explored and developed by clinical experts and accompanied with an implementation plan, to support Boards in transforming cancer pathways.

It’s anticipated that this work will initially focus on lung, prostate and Upper Gastrointestinal Series (UGI) pathways. This will be overseen by the newly formed Early Cancer Diagnosis Programme Board, Chaired by the CfSD’s National Clinical Director, Dr Catherine Calderwood.

This work will help accelerate the pathway for those with cancer to access their treatment, while providing reassurance and reducing anxiety for those who do not.

 Diagnostic capacity

Those with non-specific symptoms which indicate suspicious of cancer, often have poorer outcomes and overall patient experience. The establishment of Scotland’s first Early Cancer Diagnostic Centres (ECDCs), within the existing NHS infrastructure, provides primary care with a new referral pathway to address these issues.

Three Early Cancer Diagnostic Centres (focused on serious but non-specific symptoms that do not meet existing USC referral criteria) are now live in NHS Ayrshire & Arran, NHS Fife and NHS Dumfries & Galloway. Driven by robust evaluation, the aim is to ensure equitable access to an ECDC for patients across Scotland, reducing any geographical inequality. Similar Rapid Diagnostic Centres (RDCs) in England and Wales have demonstrated a high rate of social deprivation.

Patients will be supported throughout the pathway by a designated ‘navigator’ and have access to high quality written resources from the point of referral.

 Data to drive improvements in outcomes

The team work closely with Public Health Scotland (PHS), Scottish Government Business Intelligence Unit, academia and more to improve cancer patient outcomes. In addition, the team is supporting:

  • National Cancer Diagnosis Audit (NCDA).
  • Feeding into International Cancer Benchmark Partnership.
  • Regularly present work at international/national cancer events.
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