A comment why a CANCER CARE SPELL DELAY REASON was experienced.

This can be recorded for:

• each breach of existing service standards (introduced by the 'NHS Cancer Plan (2000)')
• the extended service standards (as specified within the 'Cancer Reform Strategy (2007)') and
• the 28 Day Faster Diagnosis Standard (introduced by the independent Cancer Taskforce 'Achieving World-Class Cancer Outcomes')

after any patient pauses have been taken into account.

The standards for which a CANCER CARE SPELL DELAY REASON COMMENT can be given are:

• maximum two week wait** for an urgent GENERAL PRACTITIONER referral for suspected cancer to Date First Seen for all suspected cancers
• maximum 28 day wait for an urgent GENERAL PRACTITIONER referral or referral for suspected cancer from an NHS Cancer Screening Programme for suspected cancer, where the CANCER FASTER DIAGNOSIS PATHWAY END REASON is National Code 'Diagnosis of cancer' or 'Ruling out of cancer'
• maximum 28 day wait for an urgent GENERAL PRACTITIONER referral, referral for breast symptoms (where cancer is not initially suspected) or referral for suspected cancer from an NHS Cancer Screening Programme for suspected cancer, where the CANCER FASTER DIAGNOSIS PATHWAY END REASON is National Code 'Diagnosis of cancer' or 'Ruling out of cancer'
• maximum one month** wait from urgent GENERAL PRACTITIONER referral for suspected cancer to First Definitive Treatment for testicular cancer, acute leukaemia and children's cancer (under 16 years of age at date of First Definitive Treatment)*
• maximum two month wait** from urgent GENERAL PRACTITIONER referral for suspected cancer to First Definitive Treatment for all cancers
• maximum one month wait** from Cancer Treatment Period Start Date (DECISION TO TREAT DATE) to First Definitive Treatment for all cancers
• maximum 31-day wait from Cancer Treatment Period Start Date (DECISION TO TREAT DATE or EARLIEST CLINICALLY APPROPRIATE DATE) to the start of second or subsequent treatment for all cancers, where the CANCER TREATMENT MODALITY is National Code 'Chemoradiotherapy', 'Teletherapy (Beam Radiation excluding Proton Therapy)','Brachytherapy' or 'Proton Therapy'
• maximum 31-day wait from Cancer Treatment Period Start Date (DECISION TO TREAT DATE or EARLIEST CLINICALLY APPROPRIATE DATE) to start of second or subsequent treatment for all cancers where the CANCER TREATMENT MODALITY is 'Surgery'
• maximum 31-day wait from Cancer Treatment Period Start Date (DECISION TO TREAT DATE or EARLIEST CLINICALLY APPROPRIATE DATE) to start of second or subsequent treatment for all cancers where the CANCER TREATMENT MODALITY is National Code 'Anti-Cancer Drug Regimen (Cytotoxic Chemotherapy)', 'Anti-Cancer Drug Regimen (Hormone Therapy)', 'Anti-Cancer Drug Regimen (Immunotherapy)' or 'Anti-Cancer Drug Regimen (other)'
• maximum 31-day wait from Cancer Treatment Period Start Date (DECISION TO TREAT DATE or EARLIEST CLINICALLY APPROPRIATE DATE) to start of second or subsequent treatment for all cancers where the CANCER TREATMENT MODALITY is other than 'Surgery', 'Anti-Cancer Drug Regimen', 'Chemoradiotherapy', 'Teletherapy (Beam Radiation excluding Proton Therapy)','Brachytherapy' or 'Proton Therapy'
• maximum 62-day wait from referral for suspected cancer from an NHS Cancer Screening Programme to First Definitive Treatment for breast, bowel and cervical cancers*
• maximum 62-day wait from a decision to upgrade the priority of a PATIENT by a CONSULTANT (or authorised member of a CONSULTANT team) to First Definitive Treatment 
• maximum two week wait** for an urgent referral for breast symptoms (where cancer is not initially suspected) to DATE FIRST SEEN.

Notes:

* Breast, bowel, cervical and testicular cancer and acute leukaemia are defined by International Classification of Diseases (ICD) diagnosis codes. The full list of diagnosis codes can be found on the NHS Digital website at: Cancer Waiting Times.

** For the performance management and the requirement to record a CANCER CARE SPELL DELAY REASON COMMENT for the above service standards, the following standardised time periods have been identified:

This attribute is also known by these names:

Context	Alias
formerly	DELAY REASON COMMENT
plural	CANCER CARE SPELL DELAY REASON COMMENTS