Investigating how the COVID-19 pandemic has affected primary care urgent cancer referrals and how can we ensure service resilience for multi-ethnic communities and the general population

In primary care, general practitioners have access to an urgent referral process for specialist investigations for those that have symptoms suggestive of cancer. This referral process has three functions:

To distinguish between non-cancer and cancer cases.

To identify cancer cases early. An early diagnosis of cancer has the important benefit of a better prognosis as treatments are more successful.

This accelerated pathway ensures that all those referred are seen in a specialist clinic within a two-week period. We often refer to it as the “two-week wait” (TWW) referral pathway.

During the COVID-19 pandemic two-week wait referrals in England, UK, were reported to have decreased by up to 84% [ ]. This has been attributed to the reallocation of health resources to address prevention and treatment of those at risk or affected by COVID-19. There has also been public apprehension to ent to their general practice with symptoms that can be associated with cancer during this time.

In this study, we will examine how often the two-week wait referral pathways were initiated within an ethnically diverse population, during the COVID- 19 pandemic. This will be referred to as the index period. We will compare the number of referrals one year prior and 1 year after the index period.

Our aim is to explore whether the two-week wait referral pathway was indeed affected by the pandemic in our multi-ethnic population of interest compared with the rest of the UK. If this is the case then we will delve deeper to detect the characteristics that contribute to this difference. We plan to identify key factors that will help us protect the two-week wait referral pathway during future pandemic situations or extreme emergencies that threaten our health care system.

Amount awarded: £50,000