Cancer

Urgent Suspicion of Cancer (USC) Referrals

Who to refer

Scottish Referral Guidelines for Suspected Cancer

The USC referral pathway is designed to allow the rapid assessment and investigation of a person with clinical features suggestive of a cancer diagnosis to determine the cause of their symptoms.

How to refer

Patients should be referred via SCI Gateway as a USC, and in accordance with the Scottish Referral Guidelines for Suspected Cancer.

NHS Tayside top tips for USC referrals.

If you are unsure about whether this is the correct referral route, please consider using the SCI Advice Option for further information.

Good practice points:

It is good practice to explain to patients that they’re being referred on a USC pathway and using the word “cancer” as a reason for investigation or referral unless there is serious concern about causing unwarranted distress. Use the Cancer Research UK resource ‘Your Suspected Cancer Referral Explained’ to support your conversations.

Further good practice is to assess general fitness, frailty, and/or performance status recording this in the referral (e.g. ECOG/WHO performance status and Clinical Frailty Scale) to facilitate discussion about the most appropriate investigations. Early optimisation or prehabilitation can enable treatment and improve outcomes. Further information and resources for patients and health care professionals is available at Prehabilitation for Scotland.

It should also be recognised that there are occasions when intrusive intervention is not in a person’s best interests. Please identify if they have dementia, if they have a POA, Guardianship, or AWI. There should be full discussion about alternative approaches, including with relevant others if a person lacks capacity, complying with the Adults with Incapacity (Scotland) Act 2000.

Cancer Referral Guidelines

	Brain and central nervous system (CNS) cancers
	Breast cancer
	Gynaecological cancers
	Haematological cancers
	Head and neck and thyroid cancers
	Lower gastrointestinal cancers
	Lung and pleural cancers
	Sarcoma and bone cancers
	Skin cancers
	Upper gastrointestinal cancers
	Urological cancers
	Non-specific symptoms of cancer
	Cancer in children and young people

Useful Resources and Information

For healthcare professionals:

NHS Tayside Top Tips for USC Referrals

Home Page - Gateway C

Realistic Medicine

The National Realistic Medicine toolkit for professionals has been published, which has further information regarding shared decision making, reducing harm, waste, and unwarranted variation, and a personalised approach to care.

Realistic Medicine - BRAN: Helping Patients ask the Right Questions

Cancer Research UK

Cancer Research UK Scottish Referral Guidelines for Suspected Cancer Overview Page

Patient Information Leaflet CRUK – Your Urgent Suspicion of Cancer Referral

Scottish Referral Guidelines for Suspected Cancer Digital Overview

Macmillan Cancer Support

Tayside Improving the Cancer Journey (ICJ) in partnership with Macmillan Cancer Support will provide practical support for patients or family of patients affected by cancer. 

Through a holistic needs assessment process with a dedicated ICJ Worker, people are invited to discuss what matters to them, to talk about how they feel and what help they may need with any emotional, practical or relationships concerns.

The ICJ Worker provides tailored information and advice and supports the person to access organisations, resources, opportunities or services near to them that could be of benefit.

Some of the concerns that ICJ can help with are:

emotional concerns such as anxiety and low mood
money worries and benefits advice
housing
caring responsibilities
feelings of isolation and loneliness
physical concerns
complementary therapies
day to day practical issues.

To find out more about ICJ and make a referral please visit: ICJ Referral Form | Dundee Health and Social Care Partnership.

Maggie's - Everyone's Home of Cancer Care

No referral or appointment required. For more information visit Maggie's Dundee

Addressing Inequalities

A practical guide has been developed by the Scottish Primary Care Cancer Group (SPCCG) that can be used to help address inequalities in cancer care - Cancer Inequalities in Scotland: A Practical Guide for GP Practices.

Safety Netting Tools

Safety netting | Cancer Research UK

Safety netting in primary care consultations | Macmillan Cancer Support

Social and Practical Support

Information on social or practical support that the person may need to help facilitate their attendance at any appointments and reduce the risk of non-attendance - Applying a missingness lens to healthcare | Enlighten