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Effect of a multidisciplinary lung investigation day on a rapid access lung cancer service
  1. A B Rajasekaran1,
  2. D Silvey2,
  3. B Leung2,
  4. D Honeybourne2,
  5. R M Cayton2,
  6. J Reynolds3,
  7. S Trotter4,
  8. M A Roland2
  1. 1West Midlands rotational training programme, Birmingham Heartlands Hospital, Birmingham, UK
  2. 2Department of Respiratory Medicine, Birmingham Heartlands Hospital
  3. 3Radiology Department, Birmingham Heartlands Hospital
  4. 4Department of Pathology, Birmingham Heartlands Hospital
  1. Correspondence to:
 Dr A B Rajasekaran
 1 Arundel Crescent, Solihull B92 8RQ, UK; thamarai2000{at}

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Lung cancer is the commonest fatal malignant disease worldwide causing more than 37 000 deaths in the UK per annum.1 The five year survival rate of 5% in the UK compares poorly with rates of up to 14% in some European countries.2 Serious concerns have also been raised about inequalities in patient access to oncology services related to the geographical location and age of the patients.3–6 The Calmann-Hine Committee report recommended a review of lung cancer services with increased emphasis on a multidisciplinary approach to care.7 Initial reports show that such multiprofessional teamwork improves coordination and patient support and reduces delays in diagnosis and treatment.8 In the British Thoracic Society (BTS) recommendations to respiratory physicians for organising the care of patients with lung cancer, emphasis was placed on reducing the delay in arranging investigations and the necessary treatment.9 In the new NHS Cancer Plan,10 the Department of Health has recommended that the maximum wait from urgent general practitioner referral to first treatment should be 62 days with a maximum wait of 31 days between diagnosis and first treatment for all cancers. Although there is little evidence to suggest that management delays adversely affect the clinical outcomes, anecdotal reports suggest that borderline resectable tumours at presentation may become unresectable if there is an inordinate delay in treatment planning. A multidisciplinary working group was established within our hospital trust to review the diagnostic journey of patients attending rapid access lung cancer clinics (RAC). The aim of the group was to rationalise this journey, to reduce waiting times, and improve the patients’ experience of this often stressful process.

Our multidisciplinary team (MDT) coordinator visited Papworth Hospital, Cambridge, UK to review their tertiary diagnostic service, as described by Laroche et al.8 An away day …

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  • Funding: none.

  • Conflicts of interest: none.

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