Non Site Specific 2WW pathway

A rapid diagnostic pathway for patients with non-specific symptoms

Your GP has invited you to be investigated by the Non Site Specific 2 week wait pathway (NSS).

This page is designed to help you to understand why the pathway is in place and what it will involve. NSS is part of a new national programme to find the quickest most efficient way to reach a diagnosis in patients who have non-specific symptoms. This page is also designed to tell you more about the purpose of the NSS pathway and what will happen over the next 2 weeks when you get referred by your GP.

For a rapid diagnosis it is important that you make yourself available for all appointments. Please take time to read the information carefully. Should you require any further information, please feel free to call the Navigator for the NSS - contact details can be found through the menu below.

Many patients visit their GP with vague or general symptoms such as weight loss and tiredness. These symptoms are called “non-specific” as they affect the whole person. Often the cause of these symptoms remains unclear after your GP has assessed you. These ‘non-specific’ symptoms may sometimes be caused by a serious disease, such as cancer but the risk of this is very low. There could be a number of reasons for these symptoms and although the risk of serious disease is low, there are some patients for whom, early tests could help make a diagnosis quicker and treatment started sooner.

This pathway is designed to give GPs a quick and efficient way to access this full group of tests for patients with “non - specific” symptoms. Patients of the UHNM NHS Trust who are referred can expect rapid diagnostic scans, (Computed Tomography or CT), possibly blood tests and if not completed by your GP a poo test. If required, an appointment with a specialist, depending on test results, will be made.

When you and your GP decide to refer using the NSS pathway, your GP will give you an information leaflet and a poo collection pack for you to collect a sample (if not already done so) which should be handed back into your GP. 

Your GP will send the Hospital team detailed information about your clinical problem - your symptoms, examination findings, medical history, and any recent test results. Our navigator will ring you with a  consultation appointment with the nurse practitioner to decide if you require a CT scan.  This could potentially be the same day as your  consultation appointment. 

The Navigator will talk you through your appointments and answer any questions you may have. Your initial consultation followed by CT scan will be within 2 weeks of referral by your GP. Please ensure you can be available for these appointments.

If you have not received an appointment within 7 days of your GP referral or if you need to change your appointment date/time then please call the Clinical Navigator on 01782 674203 or 01782 672572as soon as possible.

Your consultation will include a full history taking and detailed history of your health. This will take approximately 20 – 30 minutes. If required you will be sent for a CT scan. Any follow up appointments will be scheduled following your CT scan results.

Your CT scan will be at the Royal Stoke University Hospital in the Main X - Ray Department of the main Building on floor LG1.

The next step will be one of the following:

  1. Refer you to a Hospital specialist team.
  2. Arrange any further tests needed which will be within 2 weeks
  3. Refer you back to your GP with advice

You will need to drink a large quantity of water or squash over a relatively short period of time. This enables us to visualise your bowel on the CT scan. 

Drinking Instructions

  1. Please drink 1 litre of water or squash 2 hours prior to your examination time.
  2. You will be asked to drink a further 2 cups of water whilst waiting for your scan.
  3. You are free to empty your bladder as needed.

A CT scan is carried out by using a special X–Ray machine, which produces pictures of a cross-section or slice of the body. The scanner is of open design, not a tunnel.

Before your scan starts

Please inform a member of staff immediately before the start of your scan if you are allergic to anything.

You will be given an injection with a type of dye (known as contrast) into a vein in your arm during the scan. This will help us see the blood supply to the area we are scanning.

On very rare occasions some patients may experience a reaction to the dye, which may include symptoms such as itching or a rash, nausea, headache or dizziness.

For this reason you will be asked to remain in the department being monitored for 20 minutes following the contrast injection.

Your follow-up care will be decided by the Hospital NSS team based on your clinical information and test results. You may require more tests if further information is needed, or a referral to a specialist who will assess you in person. This could be a cancer referral or a referral for another medical condition if this is more likely.

If the results from the CT scan and other tests do not indicate that further hospital tests or treatment are needed, the NSS team will write to your GP.

If you are asked to attend a follow up appointment at the hospital we are happy for you to bring someone with you. This is often helpful when new information is being discussed and also if further tests need arranging.

We may ask you to complete a questionnaire about your experiences of the Non Site Specific Pathway to help with planning of future services for patients.

Navigator Office –  01782 674203 or 01782 672572

Nurse Practitioner – Kayleigh Bloor 01782 459357