Abstract
Introduction
The Two Week Waiting Time Standard, which requires that patients with suspected cancer referred by general practitioners should be seen within 2 weeks, was introduced in 2000. We reviewed the performance of this standard with regards to proportion of patients seen and tumour detection rates.
Methods and results
We reviewed all the referrals sent under the ‘two week’ rule from January 2004 to December 2005, to our bone and soft tissue sarcoma service. These referrals were evaluated for:
Whether or not the referral met established referral guidelines for bone and soft tissue tumours
The proportion of patients seen within two weeks
The proportion of patients referred under the guidelines that had malignant tumours.
This was compared with the total number of referrals to the unit and their tumour detection rates.
A total of 40 patients were referred under the ‘two week’ rule. 95% of these were seen within two weeks of referral. Of the 40 patients, three patients had soft tissue metastasis from a primary tumour elsewhere, and six had primary malignant soft tissue tumours. 13 had a benign bone/ soft tissue tumour. 18 (45%) patients had a non neoplastic pathology (6 Muscle tear/ herniation; 4 ganglion/bursa; 2 lumps that disappeared) During the same period a total of 507 patients were referred by other routes.
Conclusion
Only 10 of 40 patients referred under the 2-week rule had malignant tumours. The majority of referrals to our service do not fall under this rule. Significant numbers of referral under the rule are not in line with the referral guidelines. It is our impression that the 2-week rule, whilst highlighting the need of these patients to be seen urgently, may distort clinical priorities and disadvantage patients referred from other sources.
