Reporting time guidelines in relation to patient waiting targets Simon Ramsden 7 th January, 2009

1. Reporting time guidelines in relation to patient waiting targetsSimon Ramsden7th January, 2009

2. NHS Improvement plan (June 2004)‏ “By 2008 no one will wait longer than 18 weeks from GP referral to hospital treatment”

3. 18 week patient pathway By the end of December 2008 there will be a maximum of 18 weeks from referral to the start of hospital treatment. This includes all the stages that lead up to treatment, including outpatient consultations and diagnostic tests and procedures. It covers some elements that are currently measured (inpatient and outpatient waits), but crucially, other elements that were not historically measured –particularly diagnostics.

4. Conventional Cytogenetics

6. 3 days • DH:- within three days where the result is needed urgently (eg. for prenataldiagnosis)‏ • CMGS:- within 3 working days for PCR-based tests where the result is needed urgently for prenatal diagnosis • 2 weeks • DH:- within two weeks where the potential genetic mutation is already known (e.g. because another family member has already been tested)‏ • CMGS:- within 2 weeks (10 working days) for Southern blot tests where the result is needed urgently for prenatal diagnosis, PCR-based tests where the familial mutation is known, specific mutation tests, or gene tracking by microsatellite analysis • 8 weeks • DH:- within eight weeks for unknown mutations in a large gene • CMGS:- within 8 weeks (40 working days) for mutation screening within a single gene or tests that may require Southern blot analysis

7. CMGS SUGGESTIONS • Activation date is the date on which the sample (or all the required samples) and all information pertaining to the request is received by the testing laboratory. • The three day/two week turnround times for urgent tests assumes a minimum (suggest five working day) period of notification. In addition that the familial mutation is known and or informativeness is established. • Multiplex PCR tests to detect known mutations are included within “specific mutation tests”. A separate PCR test (eg. CFTR 3199del6 test to investigate a I148T mutation, polyT test or zygosity test for a non-F508 mutation detected by ARMS PCR) would have an additional 2 week reporting time. If samples are pre-screened for F508 prior to a multiplex PCR test, a single 2 week reporting time applies. • If a mutation screening test includes more than one appropriately reportable component then a turnround time of up to 8 weeks may apply to each result. • A normal Fragile X result would be reported within 2 weeks (specific mutation test), but if Southern blotting was required then an 8 week reporting time would apply for the entire test. This also applies to myotonic dystrophy and Huntington disease.