FOI2026/1932

I am interested in the role the Care gateway has in management of urgent suspected cancer (USC) referrals. 

1. Is the gateway system used for management of ALL referrals made my GP (including USC referrals) and which specialties is it used by
2. It looks as if specialist are able to redirect referrals (either back to GP, to community services or hospital services), is this used to redirect USC referrals in a similar way? If redirected back to the GP how is this communicated and in what timescale? 
3. Is this system used to either downgrade a USC referral to a less urgent priority or upgrade a referral to a USC referral. If so how is this communicated back to the GP and in what timescale? 
4. What kind of data, if any, is extractable from the system on USC referrals (such as the number of USC referrals downgraded or number redirected back to GP at specialist triage or upgraded to a USC priority) 

Is the gateway system used for management of ALL referrals made my GP (including USC referrals) and which specialties is it used by

Yes, all initial referrals including USC except for mental health referrals which still go via Gateway system but direct to Greater Manchester Mental Health NHS Foundation Trust.

It looks as if specialist are able to redirect referrals (either back to GP, to community services or hospital services), is this used to redirect USC referrals in a similar way? If redirected back to the GP how is this communicated and in what timescale? 

Yes, specialist clinicians are able to redirect referrals (either back to the GP, or other services).  If the referral is redirected back to the GP, the Gateway system has worklists which are communicated from the specialist clinician to the GP via the electronic referral system, (eRS).  Where the referral is directed to another service, the referral goes direct via eRS. 

Ordinarily, referrals received are sent to the specialist clinicians for clinical triage within 24 hours and are usually clinically triaged within 48 hours to determine where they are directed to.

For urgent, suspected cancer referrals, these are treated as a priority and are sent direct to the hospital.

Is this system used to either downgrade a USC referral to a less urgent priority or upgrade a referral to a USC referral. If so, how is this communicated back to the GP and in what timescale? 

Cancer Waiting Time standards limit the recipient from downgrading a Suspected Cancer Referral without discussion with and the permission of the referrer.

Suspected cancer referrals are sent direct to the hospital on a USC pathway via the Care Gateway Service.  USC referrals are not downgraded by the Gateway system.  Referrals are sometimes upgraded when reviewed by a specialist clinician in the Gateway system. These are then sent immediately on to the relevant department within the hospital.

What kind of data, if any, is extractable from the system on USC referrals (such as the number of USC referrals downgraded or number redirected back to GP at specialist triage or upgraded to a USC priority) 

The ICB have access to the Gateway data which includes the following fields: ‘Initial Priority’ and ‘Final Priority’ fields. These include suspected cancer referrals.