The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2024

• “interface services” means services—

  1. a

     consisting of clinical triage, assessment or treatment, other than services provided under a primary care contract,

  2. b

     to be accessed by a person who requires an elective referral, but provided before the provision of the treatment required as a result of that referral, and

  3. c

     arranged by—

     1. i

        a relevant body, or

     2. ii

        an NHS trust or NHS foundation trust in the exercise of commissioning functions that have been delegated by virtue of arrangements made under section 65Z5(1) of the 2006 Act.

Duty to make arrangements to diagnose or rule out cancer52

1

A relevant body must make arrangements to ensure that at the end of each data collection period, for persons falling within paragraph (2), the waiting time period to diagnose or rule out cancer did not exceed 28 days in at least 75% of cases where the waiting time period ended in that data collection period.

2

A person falls within this paragraph if—

a

the relevant body has responsibility for that person; and

b

they are a person in respect of whom an urgent referral has been made on or after 1st April 2024 by an eligible referrer—

i

for suspected cancer, or

ii

for breast symptoms (where cancer is not suspected).

3

The waiting time period referred to in paragraph (1) begins on the start date and ends on the date when—

a

an outcome (either a diagnosis or ruling out of cancer) is communicated to the person or, if earlier, a notification containing an outcome is sent to the person,

b

a clinical decision is made that the person requires further interval scanning or testing before a diagnosis of cancer can be made or cancer can be ruled out, or

c

a clinical decision is made that the person requires treatment before a diagnosis of cancer can be made or cancer can be ruled out.

4

Where—

a

the person concerned did not attend the first appointment made by a health service provider in response to the urgent referral, and

b

that person had not requested in advance of the first appointment that the date for that appointment be rearranged,

the period of time specified in paragraph (5) is excluded from the calculation of the waiting time period specified in paragraph (3).

5

The period of time to be excluded for the purposes of paragraph (4)—

a

begins with the start date, and

b

ends on the date on which the health service provider receives notification that the person who has been urgently referred is available again for an appointment with that provider.

6

In the exercise of its functions under paragraph (1), a relevant body must have regard to the National Institute for Health and Care Excellence Guideline “Suspected cancer: recognition and referral” published on 23rd June 2015 and updated on 2nd October 202310.

7

For the purposes of this regulation and regulation 53, cancer is to be regarded as having been ruled out either when a diagnosis of cancer has been excluded or when all reasonable steps to exclude cancer have been completed.

Duty to offer alternative provider to diagnose or rule out cancer53

1

Paragraph (2) applies where—

a

there is a person in respect of whom an urgent referral has been made on or after 1st April 2024 by an eligible referrer—

i

for suspected cancer, or

ii

for breast symptoms (where cancer is not suspected);

b

the referral is to a health service provider (“the provider”) for—

i

an appointment with a specialist, or

ii

a review of appropriate diagnostic imaging, with a view to a specialist diagnosing or ruling out cancer;

c

the referred person, or a person lawfully acting on their behalf, asks the provider or the relevant body which has responsibility for the person referred to arrange an alternative appointment or review;

d

the provider or the relevant body which has responsibility for the person referred is satisfied that:

i

the person referred will not receive a diagnosis or ruling out of cancer within 28 days beginning with the start date, and

ii

an appointment with a suitable alternative provider may expedite a diagnosis or ruling out of cancer;

e

no clinical decision has been made that the person requires further interval scanning or testing;

f

no clinical decision has been made that the person requires treatment before a diagnosis of cancer can be made or cancer can be ruled out.

2

Subject to paragraph (5), where this paragraph applies, the relevant body which has responsibility for the person referred must, in accordance with paragraphs (3) and (4), take all reasonable steps to ensure that the person is offered an appointment with a specialist or a review of appropriate diagnostic imaging by a specialist with a suitable alternative provider.

3

The appointment or review for the purposes of paragraph (2) must seek to enable the diagnosis or ruling out of cancer earlier than the person would have received were they to continue to wait for an appointment or review (as applicable) from the provider.

4

If there is more than one suitable alternative health service provider, the person referred must be offered a choice of an appointment with a specialist or a review (as appropriate) as between those providers.

5

Paragraph (2) does not apply if the person—

a

was made aware of the consequences of not attending the first appointment made by the provider in response to the referral, and

b

did not attend the first appointment.

6

In the exercise of its functions under paragraph (2), a relevant body must have regard to the NHS England Guidance “National Cancer Waiting Times Monitoring Dataset Guidance” published on 17th August 202311.”.