Non-Specific Symptoms two-week-wait pathway

Non-Specific Symptoms two-week-wait pathway

A new 2-week-wait pathway has been developed for patients who present with non-specific symptoms (NSS).  This NSS pathway should be used for patients with the following non-specific symptoms

  • Appetite loss or early satiety
  • Unexplained deep vein thrombosis
  • Diabetes with weight loss age >60
  • Unexplained fatigue
  • Unexplained fever
  • Unexplained night sweats
  • Unexplained Pallor
  • Unexplained pruritis
  • Unexplained weight loss
  • Clinician gut feeling of cancer

If patients present with these NSS, but a likely site for the cancer is identified, the patient should be referred on the site-specific 2WW pathway.

If a likely site cannot be identified, please arrange the following tests so the results will be available for the NSS pathway team

  • CXR
  • Faecal Immunochemical Test (FIT)
  • FBC, ESR or CRP, Renal with eGFR, LFT, TFT, HbA1c, TTG
  • PSA for men<
  • CA-125 for women

These tests can be selected as a “group” on DART, pick “CA Non-specific symptoms” male or female.

The referral form should be available on your clinical system, and should be sent to

This pathway is only available for patients being referred to ULHT.  NWAFT have a similar pathway (Rapid Diagnostic Service), more information can be found on this below. CCG is working to develop a similar pathway with NLAG.



NWAngliaFT Rapid Diagnostic Service (RDS+)

NWAngliaFT is introducing a new service called the Rapid Diagnostic Service (RDS+) for patients that DO NOT fit onto a 2 week wait pathway, where abnormal test results are detected. The service aims to deliver the faster diagnostic standard of 28 days, applying the 7 principles of RDC’s

This enhanced service will be led by Dr Jakki Faccenda – Consultant Respiratory Physician, supported by a multi-professional team. It will complement NOT replace existing 2 WW pathways, please continue to refer via these routes as appropriate.

The main difference in this approach is the varied routes into the service and clear outcome options for the patient. It will provide a seamless, co-ordinated DIAGNOSTIC journey for those patients that enter the system via other routes than 2WW pathways. The team will pro-actively review abnormal results and track these patients as they come through the diagnostic system, working closely with primary care.

Once the patient has a diagnosis, whether cancer or not, (within 28 days), they will be handed over to the appropriate service as per the attached pathway:

The service will be available on the e-Referral Service with effect from the 1st July, and can be found under ‘General Medicine’ Speciality as a Virtual Clinic. The patient will be triaged by the RDS+ team before having a Face to face appointment. Please ensure the patient is aware of this. Patient information leaflet attached below:


RDS+ Patient Information Leaflet


The referral proforma can be found on the Clinical Support Tool and Ardens. The new referral form (attached for information) will be available on NWAFT extranet from next week but can be obtained via Eileen Murphy/Dawn Sutton initially (as per DOS).


RDS+ Referral Form


For further details contact Eileen Murphy, Macmillan Transformation Manager at:

First Published
26 August 2021
Updated On
3 March 2024
Due to be Reviewed
31 March 2026
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