Non-Site-Specific Pathways and RDCs

Rapid Diagnostic Centre logoNon-Specific Symptoms pathways are intended to cover the cohort of patients who do not fit clearly into a single ‘urgent cancer’ referral pathway, as defined by NG12, but who are, nonetheless, at risk of being diagnosed with cancer. Symptoms considered ‘non-specific’ include unexplained weight loss, fatigue, abdominal pain or nausea; and/or a GP ‘gut feeling’ about cancer. Historically, this cohort of patients often:

  • saw their GP multiple times before referral;

  • presented more often in an emergency setting;

  • presented with late-stage cancer, and

  • were referred on multiple urgent pathways with resulting inefficiencies in healthcare provision.

Since 2019, new services have been rolled out across England to provide a dedicated urgent diagnostic pathway for this cohort of patients. The development of new NSS pathways and the optimisation of those that have already been established since 2019, remains a key priority. Cancer Alliances are working towards achieving 100% population coverage for patients with non-specific symptoms of cancer by March 2024.

Core referral criteria for NSS pathways have been outlined and can be viewed here. Cancer Alliances should note that there should be no maximum age cut off for patients to be referred onto NSS pathways. Any adult referred to NSS pathways should be triaged, investigated and safety-netted, regardless of age.

Core filter function tests for NSS pathways have been outlined here. Cancer Alliances should work with primary care to ensure that filter function tests are consistently performed and that referral forms include all the relevant information on patient symptoms and tests results for NSS pathways.

The RDC programme in Greater Manchester

The first RDC in Greater Manchester went live in summer 2020, at the Northern Care Alliance. Rollout continued until 100% population coverage was achieved in March 2022. Currently RDCs operate as follows:

  • Northern Care Alliance  NHS Foundation Trust: (one clinical team covering both sites)
    • Salford Royal
    • Rochdale Infirmary
  • Manchester Foundation Trust: (one clinical team covering both sites)
    • Wythenshawe Hospital
    • Withington Hospital
    • North Manchester General Hospital
  • Bolton Foundation Trust
  • Wigan, Wrightington and Leigh Foundation Trust
  • Tameside and Glossop Integrated Care NHS  Foundation Trust
  • Stockport Foundation Trust
Map of Greater Manchester showing RDC locations

Aligning with Community Diagnostic Centres

What is an RDC?

  • An RDC is a coordinated quality care pathway
  • Tailored Diagnostics
  • Yes / No to Cancer
  • It allows patients with non-specific symptoms to be seen quicker and not bounce around the system
  • By streamlining these patients, it frees up capacity on tumour specific pathways

What is a CDC?

  • A CDC is a building for diagnostic tests to be carried out
  • It provides services at the heart of the community
  • CDCs will provide quicker and easier access to tests
  • This will result in receiving a quicker diagnosis and receiving treatment sooner
  • Releases pressure on primary and secondary care
RDC or CDC comparison

An RDC can be set up independently of a CDC. Although the two are not integral, they should be aligned with each other to deliver the rapid assessment of patients.

Collaborative Working with the NHSE/I Beneficial Change Programme

Watch our RDC team discuss the development of the RDC at Northern Care Alliance and how the collaborative approach we have taken in GM Cancer Alliance to the development of national programmes fits with the NHSE / I Beneficial Change programme. Watch our team reflect on how shared goals / values enable improved patient experience.