Type of publication:
*Metcalfe R, *Bowen J
West Midlands Regional Neuroscience Meeting, 13 Nov 2015
An audit of the Shrewsbury and Telford two week wait CNS malignancy pathway referrals
over six months. By Metcalfe R*, Bowen J**
*Final year medical student, Keele University Medical School.
**Consultant Neurologist, Shrewsbury and Telford Hospital NHS trust (SaTH).
Word Count: 232 words.
- The overall incidence of brain tumours in the U.K. is around 7/100,001
- To promote early diagnosis a fast track “2 week wait” pathway exists for prompt diagnosis and initiation of management of brain/CNS tumours
- In SaTH standardised suspected CNS malignancy referral proformas2 are faxed to meet 2 week targets appointments
To undertake an audit to address the following:
- Did referrals adhere to proforma criteria?
- What proportion was seen within two weeks?
- Is the process fit for purpose?
- Case note review of all patients referred via the two week CNS Cancer pathway over a sixth month period from 1st July 2014 to 1st January 2015
- Over the 6 months >98 % (120/122) referred via the two week wait pathway fulfilled the
criteria on the proforma
- Only 5.7% (7/122) were not seen within two weeks
- 2 patients were diagnosed with brain metastases
- No patients were diagnosed with a primary brain tumour
- Despite adherence of over 98% no case of primary brain tumour was detected over the six month period and 2 (1.6%) of patients referred had brain metastases
- The current system is not effective at picking up brain tumours
- These results will be shared with local primary care groups and the referral criteria refined
- A reaudit to assess impact of changes will be undertaken
1. McKinney PA. J Neurol Neurosurg Psychiatry 2004;75:ii12-ii17
2. Shrewsbury and Telford Hospital NHS trust. Brain and CNS Cancer Two Week Wait
Referral Proforma. [internet] 2012 [Cited 6th October 2015] Available from: