Author: Jason Curtis

Utilisation of a Community Diagnostic Centre to Improve Colorectal Urgent Suspected Cancer Pathway Performance (2026)

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Type of publication:

Conference abstract

Author(s):

*Carter, Jack; *Goh, Yan Li; *Lacy-Colson, Jon

Citation:

British Journal of Surgery (BJS), Volume 113, Issue supplement 8.

Abstract:

Hospitals struggle to cope with the large number of patients referred on the urgent suspected cancer (USC) pathways. Diagnostic/treatment targets outlined in the NHS Long-Term Plan are often not met, resulting in long patient waiting times, increased staff workload, and high costs.

We analysed a reinvented colorectal USC pathway, utilising nurse-led, consultant-supervised clinics delivered in a community diagnostic centre (CDC). All patients received a standardised face-to-face assessment by a nurse specialist to determine the diagnostic investigation and further management. We compared the delivery of the CDC clinics with the traditional pathway in terms of time from USC referral to first outpatient appointment (OPA), time until investigation, proportion of patients meeting the Faster Diagnosis Standard (FDS), cost of pathway delivery, and time to first OPA for routine referrals.

The time to first OPA for USC referrals reduced from 14 to 3 days. The time to colonoscopy reduced from 16 to 11 days whilst the time to CT reduced from 17 to 6 days. FDS performance increased from 51% to 75%. The CDC pathway was cheaper, £373,222 per annum compared to £414,420. Additionally, time to first OPA for routine referrals reduced from 65 to 6 weeks following greater consultant availability.

We demonstrated that nurse-led clinics in a CDC can safely deliver the colorectal USC pathway with several benefits for both patients and hospital trusts. Standardising and streamlining the USC pathway in a CDC setting delivered benefits to both the USC and routine referral pathways.

DOI: 10.1093/bjs/znag087.037

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Introducing Structured Bedside Teaching for Resident Doctors PDSA 1 (2026)

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Type of publication:

Service improvement case study

Author(s):

*Rameesha Hussain, *Prajakta Jahagirdar

Citation:

SaTH Improvement Hub, May 2026

SMART Aim:

To increase structured bedside teaching for resident doctors from a baseline of 0 sessions per month to at least one structured session per month, and to improve learner satisfaction, by July 2026 through stepwise PDSA cycles.

Link to PDF poster

Elective Hub High Flow Theatre List: Combined Robotic & Non-Robotic Double HIT List (2026)

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Type of publication:

Service improvement case study

Author(s):

*Saurav Chakravartty, *Adam Farquharson, *Rebekah Tudor

Citation:

SaTH Improvement Hub, June 2026

SMART Aim:

To improve elective performance by increasing cases per list and achieving >85% theatre utilisation on 23 June 2026.

Link to PDF poster

Routine pre-operative CT imaging in Grade 2 endometrial cancer: A two-year retrospective review of clinical impact (2026)

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Type of publication:

Conference abstract

Author(s):

*Alayande G.

Citation:

BJOG: An International Journal of Obstetrics and Gynaecology. Conference: BGCS 2026 Book of Abstracts. Bristol United Kingdom. 133(Supplement 2) (pp S14), 2026. Date of Publication: 01 Jun 2026.

Abstract:

Background: The British Gynaecological Cancer Society (BGCS) guidance does not recommend routine pre-operative CT imaging in low-grade endometrial cancer due to its low diagnostic yield and limited impact on outcomes. At Shrewsbury and Telford Hospital NHS Trust, however, all patients with confirmed Grade 2 (or higher) endometrial cancer undergo preoperative CT-TAP in line with local guidance.
Objective(s): To assess adherence to local guidance and determine whether pre-operative CT influences gynaecological management. A secondary aim was to evaluate the frequency and consequences of incidental findings.
Method(s): We retrospectively reviewed patients diagnosed with Grade 2 endometrial cancer between April 2023 and May 2025 using the Somerset Cancer Register. Patients diagnosed postoperatively were excluded. Electronic records were examined to assess whether CT findings altered management, defined as referral to a tertiary centre.
Result(s): Of 52 identified patients, 46 met inclusion criteria. All underwent pre-operative CT imaging. Findings suggestive of metastatic disease were reported in 13% (6/46), prompting tertiary referral in four surgically fit patients; one was later found to have stage IA disease, representing potential overtreatment. Incidental findings occurred in 45% (21/46), with 38% (8/21) requiring further investigation. Most were clinically insignificant, though one led to a new breast cancer diagnosis.
Conclusion(s): In this cohort, routine pre-operative CT imaging in Grade 2 endometrial cancer influenced management in a clinically meaningful way. Nevertheless, potential overtreatment and the implications of incidental findings should inform imaging decisions.

DOI: 10.1111/1471-0528.70281

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Risk mitigated day case total thyroidectomy for thyrotoxicosis: analysis of factors allowing same day discharge (2026)

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Type of publication:

Journal article

Author(s):

*Crossdale M.; *Walkden G.; *Hari C.

Citation:

Ambulatory Surgery. Conference: British Association of Day Surgery Annual Conference. London United Kingdom. 32(3) (pp 185), 2026. Date of Publication: 01 Jul 2026.

Abstract:

Introduction The day case potential of total thyroidectomy has been limited by three primary risks: post-operative haemorrhage, recurrent laryngeal nerve injury with subsequent airway embarrassment and symptomatic hypocalcaemia. In response to rising elective backlogs, transitioning to a day-case model offers significant resource optimisation and improved patient satisfaction. We present the initial outcomes of a pilot day-case total thyroidectomy pathway within an NHS Trust. Methods Five consecutive patients underwent total thyroidectomy under a standardised day case protocol. The pathway prioritised: * Patient selection and education: strict surgical, anaesthetic and social criteria, informed consent and education around day case management. * Pre-operative optimisation: prophylactic loading with oral calcium and alfacalcidol. * Surgical strategy: meticulous surgical strategy (advanced bipolar techniques, haemostatic adjuncts, and Valsalva manoeuvres) to avoid drain insertion. * Biochemical monitoring: immediate post-operative PTH and serum calcium measurement. * Intended same day discharge: minimum postoperative stay 6 hours and until 20:00. * Post-operative safety net: discharge on a calcium/ alfacalcidol regimen with day one telephone follow-up and mandatory 48-hour biochemical review. Results The pilot achieved a 100% same-day discharge rate (n = 5). No post-operative haemorrhages or hematomas occurred. One patient was readmitted following the 48-hour review for mild hypocalcaemic symptoms, requiring one night of oral optimisation. The remaining four patients remained asymptomatic with stable biochemistry. Conclusion Preliminary results suggest day-case total thyroidectomy is feasible for selected patients when supported by a pathway that mitigates post-operative anaesthetic and surgical risks. While hypocalcaemia remains a concern, prophylactic supplementation and structured follow-up facilitate safe management in an ambulatory setting.

Resolving inflammatory bowel disease risk variants to genes and cell types (2026)

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Type of publication:

Journal article

Author(s):

Fachal L.; Zhang R.; Gettler K.; Haritunians T.; Cleynen I.; Stevens C.R.; Zhang Q.; Tastad C.; Medici C.; Do R.; Abreu M.T.; Achkar J.-P.; Ahmad T.; Kok K.B.; Bernstein C.; Brooks J.; Bujanda L.; *Butterworth J.; Clark K.; Cummings F.; D'Amato M.; Buono J.D.; Duerr R.H.; Ellinghaus D.; Foley S.; Franchimont D.; Franke A.; Hancock L.; Hart A.; Hooper P.; Irving P.; Jarvis M.; Johnston E.; Julia A.; Kemp C.; Kennedy N.; Kupcinskas J.; Latiano A.; Lewis J.; Li A.; Limdi J.; Louis E.; McLaughlin J.; Moayyedi P.; Moran G.; Mowat C.; Newman B.; Oglesby A.; Pekow J.; Perez K.J.; Pollok R.; Prescott N.; Radford-Smith G.; Raffals L.; Raine T.; Ramadas A.; Ramakrishnan S.; Reinisch W.; Newberry R.D.; Rogler G.; Sands B.E.; Satsangi J.; Scharl M.; Schreiber S.; Selinger C.; Shedwell S.; Silverberg M.S.; Singh S.; Steed H.; Steel A.; Uhlig H.; Verma A.; Vermeire S.; Weersma R.K.; Xavier R.; Halfvarson J.; Daly M.J.; Lamb C.; Parkes M.; Huang H.; Lee J.; McGovern D.P.B.; Rioux J.D.; Anderson C.A.; Cho J.H.

Citation:

medRxiv. (no pagination), 2026. Date of Publication: 13 May 2026.

Abstract:

Inflammatory bowel diseases (IBD), principally Crohn's disease (CD) and ulcerative colitis (UC), are common chronic disorders involving inflammation and often progressive tissue damage. Genome-wide association studies have mapped many risk signals, but the causal variants, effector genes and relevant cellular contexts remain difficult to resolve, limiting mechanistic interpretation and therapeutic translation. Here we performed a multi-ancestry GWAS meta-analysis of 125,992 individuals with IBD and more than 1.2 million controls, identifying 619 independent association signals (374 novel) at 420 IBD regions that account for 77-80% of SNP-based heritability. Fine-mapping resolved 81 high-confidence variants, 41 not previously reported. Although most signals were shared between CD and UC, 39% showed subtype specificity, with UC signals showing stronger enrichment in functional annotations from intestinal epithelial, secretory and enteroendocrine cells, and CD showing stronger genetic correlations with circulating inflammatory biomarkers, including C-reactive protein and glycoprotein acetylation. Latent causal modelling supported a causal effect of decreased high-density lipoprotein on CD risk. By integrating bulk and single-cell eQTL and pQTL resources using colocalisation and Mendelian randomisation, together with coding-variant evidence from exome sequencing, we prioritised 664 candidate effector genes across 341 signals, including 390 newly implicated IBD genes, revealing new biological mechanisms and candidate therapeutic targets supported by human genetics.

DOI: 10.64898/2026.05.13.26352926

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