The fourteen-day rule and colorectal cancer.
OBJECTIVE
To examine the effect of the fourteen-day rule on the colorectal service of a district general hospital.


METHODS
Prospective audit of all patients referred by general practitioners to the colorectal service of a district general hospital serving a population of approximately 300,000 people. The main outcome measures were: (i) mean interval in days from referral to first clinic appointment; (ii) first clinic appointment to diagnosis; and (iii) overall interval from referral to diagnosis.


RESULTS
There was a change in the referral pattern with greater numbers of 'fourteen-day rule' and urgent referrals than expected (P < 0.001). The mean time interval from referral to diagnosis was reduced (P < 0.01). This was due to a reduction in the wait for a first clinic appointment (P < 0.01). The wait between first appointment and diagnosis was unchanged (P < 0.05). Waiting times for patients referred as 'routine' or whose GPs did not specify a priority also improved.


CONCLUSIONS
The 'fourteen-day rule' with respect to colorectal cancer has reduced waiting times for a first appointment to see a specialist. Further improvements will require additional resources to reduce the delay for investigations. The effect on long-term survival remains to be seen.
Walsh
Stewart
S
Department of General Surgery, Blackpool Victoria Hospital, Blackpool, UK. srwalsh@doctors.org.uk
Bruce
Caroline
C
Bennington
Steve
S
Ravi
Srinivasan
S
D000704:Analysis of Variance; D001071:Appointments and Schedules; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000401:mortality; D005194:Family Practice / Q000592:standards; D006297:Health Services Accessibility / Q000592:standards*; D006767:Hospitals, District / Q000592:standards* / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008330:Management Audit; D017063:Outcome Assessment, Health Care; D012017:Referral and Consultation / Q000592:standards* / Q000706:statistics & numerical data; D015996:Survival Rate; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D014600:Utilization Review; D014850:Waiting Lists