ACE programme Wave 2

The ACE Programme is piloting a new diagnostic pathway for patients with ‘non-specific but concerning symptoms’ – a pathway which incorporates a Multidisciplinary Diagnostic Centre (MDC).

What is a Multidisciplinary Diagnostic Centre (MDC)?

The Multidisciplinary Diagnostic Centre (MDC) concept comes from Denmark where a patient can undergo several diagnostic tests in one location, at the same time, leading to a faster diagnosis. An MDC doesn’t have to be a new ‘centre’, but can be set up within an existing hospital or community setting and would supplement cancer-specific diagnostic pathways.

Read more about the Danish cancer pathway for patients with serious non-specific symptoms [PDF].

Read more about the Danish three-legged strategy [PDF].

The ACE programme

Discover more about the ACE programme, the latest reports, the clusters and structure of the programme.

Read more

Why pilot MDCs?

Patients who display symptoms, or a combination of ‘non-specific’ symptoms, that indicate several different cancers currently don’t have an effective referral pathway. So, as a result, go back and forth between primary and secondary care, present to emergency services or fall through the gap – which leads to delays to diagnosis and subsequently poor outcomes.

MDCs could potentially be an effective way to support patients with non-specific symptoms who tend to present late, and support GPs who are unsure of the appropriate referral pathway.

The Independent Cancer Taskforce’s strategy (July 2015) recommends MDCs as an effective way to address this current weakness in the NHS. ACE aims to action this recommendation by testing how feasible this referral route will be for the NHS in England. This pioneering pathway can include several NHS provider organisations involving primary and secondary care.

Pilots

Pilots form Wave 2 of the ACE programme, which aims to test how feasible this referral route will be for the NHS in England, and will assess the clinical and economical effectiveness of this model.

The ACE Wave 2 pilots will assess whether MDCs can effectively:

  • shift from late to early cancer diagnosis at stages 1 and 2
  • reduce the number of emergency presentation diagnoses
  • improve patient experience

The six pilots in England that make up Wave 2 of the ACE Programme are testing MDC-based pathways for patients with non-specific but concerning symptoms.

Airedale, Wharfedale and Craven

An MDC-based pathway for symptoms including recurring abdominal pain and a GP suspicion of cancer with no suitable 2WW pathway. The pilot is oncology-led with electronic referral and triage from GP and A&E.

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Bristol

The project is using two multi-modality diagnostic centres with links to primary and secondary care. The MDC-based pathway is for symptoms including abdominal pain, fatigue, weight loss and anaemia. Expansion of the project will be possible with use of mobile diagnostic units and there is ambition for a seven-day service.

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Greater Manchester

Two MDCs – physician-led and radiology-led – are being piloted for patients with symptoms including fatigue, weight loss and abdominal pain. Referrals are from GPs only.

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Leeds

A virtual MDC within shared hospital diagnostic resources. The MDC-based pathway is for symptoms including weight loss, anaemia and abdominal symptoms. Possible broadening of pathway to include self-referral.

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London

London Cancer are trialling the concept across five sites, with an MDC-based pathway for a wide range of abdominal and respiratory symptoms. Referral criteria includes patients who cannot wait for a 2WW referral and aims to broaden access to the pathway over time to include self and pharmacy referral.

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Oxfordshire

An MDC-based pathway for symptoms including weight loss, fatigue, appetite-loss and thrombocytopenia. Whole-body CT is the discriminating investigation through primary care triage. Referral is made via GP, consultant and A&E with a view to expand to self-referral.

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