A pioneering service that allows individuals to self-refer for a vital womb cancer diagnostic test has reached its one-year milestone, marking a significant advancement in women's health care.
The post-menopausal bleeding service, introduced in Somerset, has been hailed as a game-changer for those experiencing bleeding after menopause. Prior to its implementation, patients faced an average wait of 63 days to see a hospital specialist, followed by a potential 48-day wait for a cancer diagnosis.
Thanks to this innovative service, the wait time to see a specialist has dramatically reduced to just five days, with patients receiving a cancer diagnosis within 22 days of referral. This expedited process has been crucial in early detection and treatment, significantly improving patient outcomes.
Since its inception, 375 patients who met the criteria for the service have been contacted by the NHS within 24 hours for an appointment. This swift response has led to 13 patients being diagnosed with cancer at an earlier stage, providing them with more treatment options and better prognoses.
The service has also resulted in a notable increase in the number of patients in Somerset receiving a cancer diagnosis or an all-clear result within 28 days of their referral. This figure has surged from 41% in April 2023 to an impressive 76.6% in August 2024, peaking at 84% in March 2024.
Womb cancer, also known as endometrial cancer, is one of the most common cancers affecting older women and those with a womb who have undergone menopause. The primary symptom is vaginal bleeding or unusual discharge after menopause. Individuals not using contraception or hormone replacement therapy (HRT) who have not had a period for over 12 months are considered post-menopausal.
Early detection is critical, as womb cancer is typically treated with a hysterectomy (surgical removal of the womb), which generally yields positive clinical outcomes if the cancer is found at an early stage.
David Milliken, Somerset NHS Foundation Trust consultant gynaecological oncologist, commented on the service, saying:
“Since the new service has gone live, we have seen a steady increase in the number of people self-referring themselves to the service. Our aim is to see up to 50 patients a week in one of the clinics we have established across Somerset.
“We continue to see a year-on-year increase in referrals to our gynaecology cancer services for those who potentially have cancer – mainly those who’re experiencing post-menopausal bleeding.
“We know that our GP colleagues have tended to refer their patients to our service if they have post-menopausal bleeding symptoms anyway, so by allowing patients to access our service direct via a self-referral, we have reduced the wait to see a specialist from an average of 63 days to 5 days.
“Our aim is to avoid any unnecessary delays and ensure patients have an appointment much sooner. It also has the added bonus of freeing up our GP colleagues to see patients with other conditions.
“The idea is that if anyone has symptoms and wants to be seen, they can either access our service through our website, or by calling us.
“Whichever route a patient takes to reach us, they get asked a number of questions to determine whether our service is right for them, or whether we need to direct them to their GP practice.
“So far, 96% patient who have filled in a survey after their appointment has said that they were very satisfied with their overall experience.
“Over the past 12 months we have continued to refine and improve our online self-referral form with a company called C the Signs. This has allowed us to look at which other suspected cancer pathways can implement self-referral pathways.”
Traditionally, individuals with concerns about post-menopausal bleeding or unusual discharge would contact their GP. This new service, the first of its kind in the UK, allows those not currently on HRT or who stopped HRT at least six weeks ago to self-refer, streamlining the diagnostic process and ensuring quicker access to care.
The success of Somerset's post-menopausal bleeding service sets a precedent for similar initiatives across the UK, highlighting the importance of innovative healthcare solutions in improving patient outcomes and saving lives.
Image credit: iStock and Somerset NHS Foundation Trust
