Non-Specific Symptom Pathway 

Why NSS?

  • Set up for patients who presented with non-specific symptoms that could indicate several different cancers but didn’t have an established effective referral pathway.
  • As a result, these patients often went back and forth between primary and secondary care which lead to delays in diagnosis, higher rates of late stage and/or emergency presentation and poorer outcomes for the patient.
  • Since 2019, new NSS services have been rolled out across England including the South West to provide a dedicated urgent diagnostic pathway for this cohort of patients.

Core Referral Criteria

NSS pathways are intended to cover the cohort of patients who do not fit into a single ‘urgent cancer’ referral pathway, as defined by NG12, but who are, nonetheless, at risk of being diagnosed with cancer.

Symptoms include unexplained weight loss, fatigue, abdominal pain or nausea; and / or GP ‘gut feeling’ about cancer.  Historically, this cohort of patients often:

  • Saw their GP multiple times before referral
  • Presented more often in an emergency setting
  • Presented with late-stage cancer and
  • Were referred on multiple urgent pathways

Filter Function Tests

Filter function tests should be used prior to referral in order to:

  • Support GPs to refer patients via the most appropriate route ( i.e. nonspecific symptoms or site specific), leading to a higher referral quality
  • Reduce the risk of test duplication later in a patients pathway
  • Ensure all necessary pre-investigation testing has been completed, removing potential delays further along the pathway.