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首页> 美国卫生研究院文献>Journal of Healthcare Leadership >Transforming cancer outcomes in England: earlier and faster diagnoses pathways to success and empowering alliances
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Transforming cancer outcomes in England: earlier and faster diagnoses pathways to success and empowering alliances

机译：改变英国的癌症结局：更早更快速的诊断成功之路并增强联盟实力

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Cancer outcomes and patient experience in England have never been better but survival remains worse than in comparable countries. Differences in stage at diagnosis and, to a lesser extent, access to optimal treatments are likely to be the most important factors. The national cancer plan emphasizes earlier and faster diagnosis and the creation of cancer alliances providing strategic leadership and coordination. Earlier diagnosis is being promoted by national awareness campaigns designed to overcome fatalism and perceived barriers to consulting a general practitioner as well as improvements to existing screening programs and the introduction of more targeted screening such as Lung Health Checks. These are supported by local social marketing campaigns in which trained volunteers support and advise others about cancer and cancer care. The epidemiology of symptoms in general practice provides an organizing framework for cancer diagnostic pathways. Alliances are implementing a broader model of cancer diagnostic clinics at a larger scale taking into account the different needs of patients with 1) obvious alert symptoms, 2) low risk but not no risk symptoms, and 3) serious but not specific symptoms. Faster diagnosis is being promoted by the introduction of a Faster Diagnosis Standard requiring patients are given a diagnosis of cancer or have it ruled out within 28 days of referral. The three cancer alliances forming the National Cancer Vanguard together with NHS England are publishing clinically led evidence-based Timed Diagnostic Pathways which show how the drastic changes needed can be achieved. Cancer alliances have been successful in developing clinical cancer pathways which need support by improved commissioning and regulatory approaches which align clinical pathways with financial and performance ratings. Clinical leadership has been essential but further focus is needed on making sure that performance and regulatory approaches give proper attention and encouragement to earlier and faster diagnosis.
机译：在英国，癌症的结局和患者的经验从未比现在更好，但是存活率仍然比同类国家差。诊断时的阶段差异以及在较小程度上获得最佳治疗的差异可能是最重要的因素。国家癌症计划强调早期诊断和更快诊断，以及建立癌症联盟以提供战略领导和协调。通过开展全国意识运动来提高早期诊断水平，这些运动旨在克服宿命论和咨询全科医生的障碍，并改善现有的筛查计划，并引入更具针对性的筛查，例如肺部健康检查。这些活动得到了当地社会营销活动的支持，在这些活动中，训练有素的志愿者支持并就癌症和癌症治疗向其他人提供建议。一般实践中，症状的流行病学为癌症诊断途径提供了组织框架。联盟考虑到以下患者的不同需求，正在大规模实施更广泛的癌症诊断诊所模型：1）明显的警报症状，2）低风险但无风险症状，以及3）严重但无特定症状。通过引入“快速诊断标准”来促进更快的诊断，该标准要求患者接受癌症诊断或在转诊后的28天内排除癌症。与英国NHS一起组成国家癌症先锋队的三个癌症联盟正在发布临床主导的循证定时诊断途径，这些途径展示了如何实现所需的巨大改变。癌症联盟已成功开发出临床癌症途径，需要通过改进的调试和监管方法来支持，以使临床途径与财务和绩效评级保持一致。临床领导一直是必不可少的，但需要进一步关注确保性能和调节方法适当注意和鼓励早期和更快的诊断。

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