Urgent Suspected Cancer: referral forms

In January 2023, we published revised pan-London Urgent Suspected Cancer (USC) referral forms (previously known as Two Week Wait referrals). These are available for EmisWeb, SystmOne, and Vision, as well as being available to download in MS Word format.

The revised forms aim to better promote the inclusion of key information on the reason(s) for USC referral, and inclusion of all information necessary for triage and rapid assessment by the receiving hospital.

A video on how to make a good quality referral will be available here in due course.

Changes to the forms include:

  • the addition of a section to record history, physical examination findings and reasons why the patient may have cancer;
  • clearer directions to alternative management and referral options if a patient does not meet the defined USC referral criteria;
  • the addition of a link for learning disability contacts in London;
  • ‘Top tips’ boxes on the breast and lower GI forms (top tips for gynaecological, haematological, upper GI and urology forms are in development);
  • Updated patient information leaflets in a range of community languages to support patients who have been referred to hospital with a suspected cancer.

Find out more about the generic changes as well as tumour site-specific form changes.

GPs, dentists and optometrists in all London boroughs are advised to use the pan-London USC referral forms when referring patients with a suspected cancer, as they contain the updated guidelines from NICE published in 2015 (NG12) as well as additional tumour-specific referral criteria and deviations which have been agreed for the London area.

While guidelines assist the practice of healthcare professionals, they do not replace their knowledge, skills or clinical judgement. NG12 also supports clinicians to refer patients appropriately where cancer is suspected even if the patient does not meet NG12/Pan-London referral criteria.

Referrers should include as much clinical and patient sensitive information as possible to enable swift triage and processing.

Useful information

Below you can find educational information, links and data that you may find useful.

Electronic Referral System (e-RS)

The Electronic Referral System (e-RS), formally known as choose and book, is the preferred booking method for suspected cancer referrals. A national standard set by NHS England states that by October 2018 all first consultant led appointments (including 2ww) should be booked via e-RS. The e-RS improves reliability and patient safety which is consistent with good practice, as well as improving patient experience. If e-RS is not available then referrer should email the referral form to the provider using the directory at the top of each referral form.

2 Week Wait e-referral primary care user guide (2018)

Queries and support

If you have any questions regarding the referral forms or associated educational information please email: england.tcstlondon@nhs.net