The NHS two week wait skin cancer referral pathway: analysis and recommendations for process improvement.

Abstract

Background: While pressures on the National Health Service skin cancer services have predated the COVID pandemic, the two -week-wait (2WW) skin cancer standards have deteriorated post-pandemic.

Methods: The 2WW skin cancer pathway is analysed in this report utilising 4V typology and volume-variety matrix. Performance matrix of the 2WW skin cancer pathway and SIPOC analysis are also examined. Recommendations are provided following analysis and redesign of the process map of the pathway.

Results: Process analysis has enabled identification of some of the limitations of the 2WW skin cancer pathway. This has led to recommendations including lesion assessment using artificial intelligence, single lesion assessment clinics and direct access skin surgery, all of which aim to expedite patient care and increase capacity in 2WW clinics.

Conclusions: Process analysis of the 2WW skin cancer pathway provides useful insights and helps identify bottlenecks in the system. Recommendations following remapping the process offer potential solutions to help reducing time to referral and increasing capacity. These recommendations should help reduce waiting times for patients receiving initial diagnosis and subsequent definitive treatment for suspected skin cancers.