A nurse-led model for suspected prostate cancer referral v1

  • Research type

    Research Study

  • Full title

    Improving the suspected prostate cancer diagnosis pathway: a hybrid effectiveness-implementation evaluation of an advanced cancer nurse specialist-led model in Fife.

  • IRAS ID

    326327

  • Contact name

    Erica Gadsby

  • Contact email

    e.j.gadsby@stir.ac.uk

  • Sponsor organisation

    University of Stirling

  • Duration of Study in the UK

    1 years, 6 months, 1 days

  • Research summary

    Background
    Referrals to Fife urology oncology team with suspected prostate cancer are currently assessed by a consultant in clinic, with further investigations requested/conducted as required. Following assessment, the patient attends a histology/news clinic where they meet the advanced clinical nurse specialist (ACNS) to discuss diagnosis. There has been a steady increase in urology referrals since 2019, and there are significant delays and variations across the patient pathways. The improvement proposed in this project has the potential to improve patient outcomes and experience, improve the vetting of cancer referrals, free up capacity amongst urology consultants, and help NHS Fife to meet national cancer targets for prostate cancer.
    Aims
    To develop, implement, evaluate and assess the scalability of a specialist nurse-led diagnostic model, to improve the process from referral to diagnosis up until decision to treat.
    Methods
    Phase 1 (months 1-3), set-up: establish stakeholder group and PPI; develop intervention and implementation plan; finalise evaluation framework, approach and methods; secure ethics approval; explore, with stakeholders, the contextual factors and expected facilitators and barriers to implementation.
    Phase 2 (months 3-15), implementation: implement improvement and adapt as necessary in response to evaluation data. Evaluation methods will include using routine health services data, patient surveys, and staff interviews. Analyses will include: statistical analyses (including before/after comparisons) and economic analyses; descriptive analyses of demographic data; thematic analyses of qualitative data.
    Phase 3 (months 1-18), scalability and evaluability assessment. To begin at project initiation, with evidence synthesised in months 15-18.
    Value
    This project will result in: a tried and tested improvement, with evidence of how and why it ‘worked’ as it did; a detailed assessment of scalability; an assessment of the anticipated long-term impact, particularly in terms of reducing inequalities in health; and an assessment of its evaluability on a larger scale.

  • REC name

    South Central - Oxford A Research Ethics Committee

  • REC reference

    23/SC/0252

  • Date of REC Opinion

    21 Jul 2023

  • REC opinion

    Favourable Opinion