Maria Crisford and colleagues report on a local audit that reveals how telephone assessments can reduce the time to investigation for patients with the symptoms of colorectal cancer

The two-week rule was introduced to address delays in cancer diagnosis. It requires patients with suspected cancer to be seen by a specialist within two weeks of GP referral and has implications for colorectal departments in terms of managing demands on service provision.

In one NHS trust it was addressed by introducing a nurse-led telephone triage assessment to determine patients’ suitability for investigations before attending outpatient clinic. The assessment was developed by a Delphi survey. An audit evaluated whether time from referral to investigation had reduced since introduction of the assessment.

Data were collected retrospectively from 40 patients before its introduction and compared with 40 patients after its introduction. Time to investigation was reduced in the telephone assessment group: a mean of 12.5 days versus 21.2 days, with a mean difference of -8.7 days.

Introduction of telephone assessment reduced time from GP referral to investigation and enabled earlier detection of cancer in line with healthcare policy.