Background Rapid Diagnostic Clinics (RDC) are being expanded nationally by NHS England. Guy’s RDC established a pathway for GPs and internal referrals for patients with symptoms concerning for malignancy not suitable for a site-specific 2WW referral. However, little data assessing the effectiveness of RDC models are available in an English population. Methods We evaluated all patients referred to Guy’s RDC between December 2016 and June 2019 (n = 1341) to assess the rate of cancer diagnoses, frequency of benign conditions and effectiveness of the service. Results There were 96 new cancer diagnoses (7.2%): lung (16%), haematological (13%) and colorectal (12%)—with stage IV being most frequent (40%). Median time to definitive cancer diagnosis was 28 days (IQR 15–47) and treatment 56 days (IQR 32–84). In all, 75% were suitable for treatment: surgery (26%), systemic (24%) and radiotherapy (14%). Over 180 serious non-neoplastic conditions were diagnosed (35.8%) of patients with no significant findings in two-third of patients (57.0%). Conclusions RDCs provide GPs with a streamlined pathway for patients with complex non-site-specific symptoms that can be challenging for primary care. The 7% rate of cancer diagnosis exceeds many 2WW pathways and a third of patients presented with significant non-cancer diagnoses, which justifies the need for rapid diagnostics. Rapid Diagnostic Centres (RDCs) are being rolled out nationally by NHS England and NHS Improvement as part of the NHS long-term plan. The aim is for a primary care referral pathway that streamlines diagnostics, patient journey, clinical outcomes and patient experience. This pilot study of 1341 patients provides an in-depth analysis of the largest single RDC in England. Cancer was diagnosed in 7% of patients and serious non-cancer conditions in 36%—justifying the RDC approach in vague symptom patients.

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303 Background: Rapid Diagnostic Clinics (RDC) are being set up across the UK allow primary care physicians to refer patients with symptoms concerning for cancer that do not fulfil tumour-specific two week wait urgent referral criteria. Guy’s RDC was established to address the high cancer related mortality in our network. There is little data assessing the effectiveness of RDC models is available in a British population. Methods: We evaluated all patients referred to Guy’s RDC pilot scheme between December 2016-June 2019 (n=1,341) to assess the rate and type of cancer diagnosed and clinical outcomes. Results: Of 1341 patients, 96 cancers were diagnoses (7.2%). Most common were lung (16%), haematological (13%) and colorectal (12%). A third were at early stage (I-II) and 40% received radical treatment. Median time to cancer diagnosis 28 days (IQR 15-47) and treatment 56 days (IQR 32-84). 75% of patients were suitable for anti-cancer treatment: surgery (26%), systemic (24%) and radiotherapy (14%). We plan to present updated data on > 2000 patients referred until June 2020. Overall 6% of patients were diagnosed with pre-malignant conditions. Conclusions: RDCs provide a streamlined pathway for complex vague symptoms patients which are challenging for primary care. The 7% rate of cancer diagnosis exceeds many tumour specific urgent pathways which supports the need for rapid tailored diagnostics. The detection of pre-malignant conditions in 6% allows surveillance and intervention to potentially improve long-term outcomes. RDCs are likely to be pivotal in the cancer recovery phase of the COVID-19 pandemic.

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