GP refers patient.
CXR suspicious for lung cancer?
no
Report sent to GP. No further action.
yes
Report using X15 code to recommend CT scan.
Hard copy report sent to GP and Judith Job in CT.
Christine Roberts to cover when Judith is away.
Judith allocates patient appointment for staging CT scan within one week using dedicated X-ray form (Dr
Woolhouse as named referrer).
Judith telephones patient to:
1. Offer them a CT appointment.
QED and lung CNS to provide written advice on how to deal with patient queries as to the need for CT.
Lung CNS can provide a follow up phone call if required.
2. Check and document history of Diabetes, Kidney disease, Myeloma or Organ Transplant.
If the patient has any of these conditions then a creatinine measurement from the last 3 months is required.
Judy to first check PAS viewer and then phone GP surgery for creatinine result. If no creatinine result
available then standard letter to be faxed to GP surgery requesting that creatinine is measured and result
faxed back to CT. Note: The usual checklist will still be completed pre-contrast injection to ensure that there
are no contraindications.
If Judith is unable to contact the patient by telephone then a CT appointment letter will be posted to the
patient. To include an additional paragraph requesting the patient to contact the CT department if they have a
history of Diabetes, Kidney disease, Myeloma or Organ Transplant so that the above measures can
undertaken to ensure that a recent creatinine measurement is available.
Judith to keep a list of all patient patients whom have been booked a CT as part of this pathway. list to include
name, hospital number, DOB, date of CT appointment. List to be emailed to lung cancer nurse specialists, Dr
Woolhouse and the relevant radiologists (Dr Walker, Dr Holloway) each week.
no
Patient attends for staging CT scan?
Judy to contact patient and
offer further appointment
Patient attends for staging
CT scan?
yes
yes
Staging CT scan performed (go to next page)
no
Judy informs Dr Woolhouse
who contacts patient’s GP with
offer of a clinic appointment
Lung Pathway updated
21/5/10 Dr Woolhouse
1
Staging CT scan performed
Patient given information leaflet
Suspicious of Lung Cancer?
Report to be emailed to QED
(Copy to Ruth Parry, Rani Ubhi, Carolyn Russell,
Sophie Phillips, Toni Devaney)
QED to arrange urgent (within one week) lung
clinic appointment
(Hard copy report to Dr Woolhouse)
yes
no
Report to Dr Woolhouse via Toni Devaney
Toni to keep list and check all patients are
subsequently discussed at diagnostic meeting
All CTs reviewed at Friday diagnostic meeting using Judith’s list.
Suspicious CT results
- Check patients have been made an urgent lung appt.
- Recommend method of diagnostic biopsy (if clinically appropriate) pending clinic appointment
Non-suspicious CT results
-Template letters sent from Dr Woolhouse secretary to patient and patient’s GP
Clinic appointment
Check clotting and spirometry if necessary
Lung CNS to give date for biopsy if appropriate
Diagnostic biopsy
Lung MDT meeting
Lung Pathway updated
21/5/10 Dr Woolhouse
2