A three-month pilot was run from 1 st April 2022 to 30 th June 2022, and was funded by the Cancer Alliance. To differentiate from the RDS pathway, it was renamed the Lower GI support service (LGISS). The pilot was delayed due to procedural issues so only started receiving referrals from 17 th May 2022, the service had the following outcomes: • 136 patients were transferred from the 2 week wait LGI cancer pathway to the LGISS during the pilot in May and June 2022. An audit of 50 patients assessed the quality of referrals, patient management, and the diagnosis. • From 15 th August 2022 until 25 th January 2023 a further 301 patients had been transferred to the LGISS. An audit of 150 of these referrals concentrated on the management and diagnosis. The positive outcomes of the service included a reduction in pressure on Lower GI 2 week wait cancer pathways, which resulted in reduced waiting times and increased colon cancer detection rates. Patients on the NNUH waiting list fell from over 1000 in August 2022 to circa 600 in November 2022. As the work continued, these figures further improved. This service demonstrated improved patient care, avoiding unnecessary investigations and reduced waiting times (86.6-94.6% patients seen and discharged within 6-weeks), with patient satisfaction of the service being rated highly. GPs also benefited from the service as the patient pathway was completed with onward referral if necessary, alongside the provision of advice and guidance (A&G) to improve learning.
It is suggested that other pathways for specific other lower GI conditions would benefit from similar support.
The work which NNPC has undertaken was nominated for an award from The British Society of Gastroenterologist Awards and came 2 nd out of 19 entries. The pilot stopped on the 30 th June 2022. Both the NNUH and NNPC hoped to continue the service because of the positive impact on patients and the improved performance in the Trust. Further funding was secured from the Norfolk & Waveney ICB, so the service resumed on the 15 th August 2022 with funding until the 31 st March 2023. It is hoped that this service will run beyond this time and will be rolled out across all 3 Acute Trusts in the region.
Home Visiting Service – Great Yarmouth & Waveney
In October 2022, NNPC was contracted by Great Yarmouth & Waveney ICB to deliver a home visiting service for 7 practices in the Great Yarmouth, Northern villages, and Gorleston area. This service was initially contracted until 31 st March 2023, but has since been extended until 30 th June 2023. The home visiting team are based at Shrublands Health Centre in Great Yarmouth, which provides good links with the local community nursing team, who also uses this as their base.
The home visiting service has provided and carried out a total of 1,212 home visits between the start of the service in October 2002 up to the end of March 2023. These visits have supported the
NNPC Quality Account 2022/23
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