Rapid cancer diagnostic service (RCDS)

Borders Ref Help Toolkit
NHS Borders

RCDS is a person-centred fast-track diagnostic pathway which aims to provide Primary Care with an alternative route to refer patients with non-specific symptoms, such as weight loss, fatigue and nausea that are suspicious of cancer but do not fit an existing tumour site pathway.

 

Who to refer, who not to refer, how to refer

Referral / Inclusion Criteria:

  • GP Clinical Suspicion / "gut feeling" of cancer but not indicative of tumour site
  • Unexplained Weight Loss
  • Severe unexplained fatigue
  • New atypical pain (e.g. diffuse abdominal pain or bone pain)
  • Unexplained laboratory test findings (e.g. Thrombocytosis potentially indicative of lung, endometrial, gastric, oesophageal and colorectal (LEGO-C) cancers)
  • Persistent nausea or appetite loss
  • >18 years of age
  • The patient is well enough to go through the process
  • RCDS bundle investigations have been requested
  • There is no other urgent referral pathway suitable for this clinical scenario

Exclusion Criteria

  • Patients already on or suitable for a specialty specific urgent suspicion of cancer referral pathway
  • Referrals from Secondary Care or non-Borders residents
  • Patients aged <18
  • Symptoms likely due to recurrence of previous cancer - refer to previous specialty
  • Patient too unwell to attend or likely to require acute admission
  • A serious non-cancer diagnosis is likely - these should be referred to the appropriate specialty

Access is by referral only, via a dedicated SCI-Gateway template.

Primary care management

Please advise the patient that the role of RCDS is to investigate for potential cancer.

Please ensure chest, abdominal and lymph node examinations plus urinalysis are documented in your referral.

Please ensure samples for FBC, ESR, U&E, LFT, gGT, CRP, Calcium & Bone Profile, Ferritin, Transferrin, Coeliac (TTG) antibodies, TFT, Glucose, HbA1c, PSA (men), CA125 (women) have been collected prior to referral.

Recent weight trend, Qfit, myeloma screen, and CXR are not mandatory but would be welcomed as clinically indicated.

To expedite the patient journey CT scanning may take place before RCDS clinic review.  We need your examination findings documented in SCI-Gateway and blood samples collected to make this possible and ensure our radiology colleagues have all relevant clinical information.

Resources and links

Scottish Cancer Referral Guidelines

 

Patient information video

Local service contact details

Enquiries to: Ellie Temple

Direct Line: 01896 826815

E-mail: bor.rcds@borders.scot.nhs.uk

Editorial Information

Last reviewed: 01/10/2024

Next review date: 01/10/2025

Author(s): Dr Robin Kerr.

Author email(s): robin.kerr@nhs.scot.