RCDS key principles and optimal components

The national RCDS Oversight Group developed seven key principles, which have all been embedded in the RCDS pathways. These are:​

• ​Excellent patient coordination and support with patients having an assigned ‘navigator’ throughout their diagnostic pathway alongside access to accurate resources, to inform decision-making ​
• Early identification of patients that meet RCDS referral criteria, with timely referral to the service and a suite of preliminary tests completed ​
• Prompt Active Clinical Referral Triage (ACRT) undertaken​
• Coordinated testing, based on the patient’s needs in a ‘one-stop’ environment where possible, with live or rapid reporting, shortening the diagnostic pathway​
• Earlier diagnosis of cancer, or other condition(s), shared appropriately with the patient and the outcome speedily communicated back to primary care along with next steps​
• Appropriate onward referral for further support, treatment, or care​
• Adoption of the principles of Realistic Medicine throughout.​

“I was losing weight and was quite worried, so I booked an appointment with my General Practitioner. My General Practitioner was very good and immediately referred me to the RCDS (…). Within a day or two I was contacted (…) and given an initial assessment. After that assessment I was offered a CT scan and again within days had the all-clear result. I am a regular attender at the hospital (…) and I can honestly say I have never had such a good service as the RCDS. All the staff were polite, courteous and very professional. I cannot fault anything about this service. The speed of scans and results was impressive as was the care and attention from the staff. The speed took a weight of my mind. I wish all departments could operate with such speed."​

RCDS patient

The following components have also been found to contribute to an effective RCDS model in NHS Scotland for patients with non-specific symptoms suspicious of cancer: ​

• Prompt vetting and triage of referrals by the RCDS team, from primary care or otherwise​
• Personalised single point of contact provided for each patient (‘patient navigator’)​
• Coordinated testing, particularly close liaison with the radiology department (given reliance on CT as a diagnostic test)​
• Diagnostic decision-making by the RCDS team/multi-disciplinary team​
• Appropriate onward referrals by the RCDS team for patients with an initial diagnosis or suspicion of cancer to a site-specific cancer pathway.​

"Thanks to the RCDS team for a fast, efficient and very patient orientated service. After the initial telephone call the speed of appointments was quite amazing. The staff were great and gave me all the information needed to ensure I understood everything that would be happening regarding the necessary scans etc. The caring attitude of the staff took a huge weight of my mind during a worrying time."​

RCDS patient