Rapid Diagnostic Service

The Rapid Diagnostic Service (RDS) is a service designed to investigate patients with vague (non-specific) symptoms quickly in an effort to diagnose cancer or other serious conditions earlier. The pathway at Harrogate District Hospital is called the Serious, Non-specific Symptoms Pathway (SNSP)

Prior to the RDS, patients may have been referred to numerous specialists before reaching a diagnosis.

Meet our RDS Team

The RDS team is made up of a Multidisciplinary Team (MDT) who work together to diagnose and identify the best course of treatment for each patient.

The Medical Team
Dr Adam Culverwell, Consultant Radiologist
Dr Ganesh Sivaji, Consultant Gastroenterologist
Mr John Simpson, Consultant General Surgeon

The Nursing Team
Our nurse specialists have experience in cancer nursing and specialise in the care and support of patients with a diagnosis. The team comprises of an Advanced Nurse Practitioner (ANP), Clinical Nurse Specialist (CNS) a Rapid Diagnostic Service Coordinator and a Rapid Diagnostic Service Administrative Officer. Our Nursing team are:

• Mel Aubin, Lead Nurse & Advanced Nurse Practitioner
• Alison Sharpe, Clinical Nurse Specialist
• Louise Gregg, Rapid Diagnostic Service Coordinator
• Mandie Thrippleton, Rapid Diagnostic Service Admin Officer

Who can be referred to the RDS? 

Your GP may refer you after some initial tests to the RDS if you have symptoms such as unexplained weight loss, unexplained pain or fatigue. The service is open to all patients over the age of 18.

What happens after my GP refers me?

Once referred by your GP the Nursing Team will review the referral and book you into a clinic appointment within seven days. The RDS team will aim to contact you within two working days with the appointment information.

You will be seen and assessed in the Nurse led clinic which takes place in Zone 2, Main Outpatients Department at Harrogate District Hospital. You may have further blood tests during this appointment.

Following the clinic appointment you will be discussed the next day with the RDS Multidisciplinary team where they will decide what tests you may need. Tests may include scans (imaging services) or endoscopy. You will be contacted over the telephone by the nursing team to discuss these.

Once you have had the appropriate tests you will be reviewed in the nurse led clinic with the results which we aim to be within 28 days of your referral. If needed you will be referred to a specialist team if not you will be referred back to your GP.

How do I contact the RDS?

If you have any questions or concerns whilst waiting for the tests you can contact the RDS nursing team who will act as a single point of contact for you.

We work Monday to Friday 8:30 am to 4:30pm and can be contacted on 01423 557981.

We also have an answer machine which is checked regularly throughout the working day.

Are other pathways included in the RDS?

Yes, you may be contacted by a member of the RDS team if your GP has referred you to the suspected prostate cancer, lung or suspected lower or upper gastrointestinal cancer pathway. You will be informed as to what the next steps are and provided with our contact information.

Useful Patient Information

Living Well:

Making healthy choices including eating a balanced diet, healthy weight, exercise, quitting smoking and drinking less alcohol aims to help people live longer and healthier lives.

https://www.nhs.uk/live-well/

Signs and Symptoms of Cancer:

Although unlikely to be cancer, finding cancer earlier can make it easier to treat. It is important that you are aware of any worrying or new symptoms and that you speak to your GP to investigate.

https://www.nhs.uk/conditions/cancer/symptoms/

Cancer Screening:

In England we have 3 screening programmes; Cervical screening; Bowel screening and Breast screening.

It is important that if you are eligible you make every effort to take part. Screening tests can detect a problem early, before you have any symptoms and this can mean that treatment is more effective.

Cervical Screening

https://www.nhs.uk/conditions/cervical-screening/

Bowel Screening

https://www.nhs.uk/conditions/bowel-cancer-screening/

Breast Screening

https://www.nhs.uk/conditions/breast-screening-mammogram/

Referral Information for healthcare professionals

The Serious, Non-Specific Symptoms Pathway (SNSP) is a suspected cancer pathway under the 28 day faster diagnosis standard (FDS) and is open to referrals from GP Practices within the Harrogate District.

Referrals are made via e-RS. The SNSP service is found within 2 week wait. Service ID 7977812. We are developing a referral pathway for clinicians within Harrogate and District NHS Foundation Trust.

Referral Criteria

Patients 18 and over with the following criteria can be referred in to the service:

  • New unexplained and unintentional weight loss (either documented ˃5% in three months or strong clinical suspicion)
  • New unexplained vague abdominal pain for four weeks or more (less if very significant concern) with no associated change in bowel habit
  • New unexplained constitutional symptoms for four weeks or more (less if very significant concern) Symptoms include loss of appetite, fatigue, nausea, bloating or malaise
  • GP ‘gut feeling’ of cancer diagnosis

The exclusion criteria:

  • Patient fulfils criteria for a site specific suspected cancer pathway.
  • Patient is too unwell or unable to attend as an outpatient or needs acute admission
  • Patient is likely to have a non-cancer diagnosis suitable for another specialist pathway
  • Patient is currently being investigated for the same problem by another specialist team

If you would like advice or to discuss a patient prior to referral then please contact the RDS on 014213 557981 or email the team at hdft.rapiddiagnosticcentre@nhs.net

Filter Tests

The following tests are required prior to referral to the SNSP service and can be found within Health Checks on ICE (for hospital staff within Medicine Profile):

  • FBC
  • U&E
  • LFT
  • Ca 125 (F) PSA (m)
  • TFT
  • HbA1c
  • Coeliac screen
  • Calcium/bone profile
  • Urine analysis
  • FIT
  • Chest X-Ray

What happens next?

All bookings via e-RS are provisional and the referral is triaged.

Information leaflets for patients are available on e-RS within the referral form.

The RDS team monitor e-RS throughout the day and referrals are triaged by a member of the clinical team. If accepted an appointment is made for the patient in the Nurse Led RDS clinic. The patient is contacted and confirmation of the appointment is made and given the RDS coordinator details, who acts as a single point of contact throughout their diagnostic journey.

If the referral is more suited to a site specific pathway the RDS team will refer. If the patient does not meet the referral criteria the Surgery will be contacted and advice given.

Following investigation and MDT discussion patients are discharged either to:

  • A specialist cancer MDT if cancer is diagnosed
  • Other speciality for onward management
  • Back to GP with advice as required for onward management