Days Matter: Improving Urology Cancer Pathways at North Bristol NHS Trust

By Penny Heaton | October 22, 2025

The Challenge

North Bristol NHS Trust (NBT) was facing delays in its urology cancer pathway, especially for prostate cancer. Patients were waiting up to 15 days for their first clinic appointment and up to two weeks for MRI scans. These delays caused anxiety and risked missing national cancer targets.

A backlog of patients waiting to be triaged, limited MRI availability, and inefficient booking systems were adding pressure. Multidisciplinary team (MDT) meetings were overloaded with up to 100 cases, making it harder for clinicians to focus on complex patients.

NBT needed to speed up diagnosis and decision-making while keeping care safe and sustainable.

The Approach 

NBT has taken a joined-up approach, combining digital innovation, process redesign, and team collaboration to improve the pathway:

  • Faster Triage: The team removed the backlog by introducing direct booking into clinics and removing delays in MRI scheduling. Most patients are now triaged within two days, with plans for daily triage.
  • Straight-to-Test MRI: A new pathway is being developed to allow selected patients to have their MRI scan on the same day as their referral, cutting waits from two weeks to just 2–3 days.
  • Smarter MDT Meetings: A consultant-led initiative introduced AI-supported coding to filter out straightforward cases, reducing MDT lists from 100 to just 15 patients. This frees up time for more complex discussions.
  • Digital Tools: NBT has submitted a bid to expand the use of AI tools (like Copilot) to help with MRI scheduling, admin tasks, and communication, making the system more efficient and sustainable.
  • Collaborative Working: These changes have been supported by close collaboration between urology, radiology, cancer services, and SWAG Cancer Alliance.

NBT adopted a multi-pronged strategy combining process redesign, digital innovation, and workforce optimisation.

What Does This Mean for Patients and Staff?

For patients, this means:

  • Faster access to appointments and scans
  • Quicker decisions about their care
  • A smoother, more predictable journey with fewer delays

For staff, it means:

  • Less time spent on admin and routine cases
  • More time for complex patients
  • Improved job satisfaction and team morale
  • Opportunities to develop digital skills and work in more innovative ways

Impact to Date 

NBT has already seen strong results:

  • Triage backlog cleared
  • 75% of patients triaged within two days
  • Referral-to-clinic time reduced from 15 to 5 days
  • MRI report turnaround cut from 7 to 2 days
  • Seven extra clinic slots added per session
  • MDT caseload reduced from 80–100 to 15 patients

Clinicians report better workflow and reduced stress, while patients feel more confident in the speed and clarity of their care.

Next Steps 

NBT plans to:

  • Expand the straight-to-test MRI pathway across prostate cancer services
  • Fully implement AI tools to streamline admin and booking
  • Continue working with radiology to improve scan vetting and reporting
  • Address surgical capacity challenges at Weston
  • Share learning across SWAG to help develop a regional best practice framework
  • Embed digital skills and secure long-term funding to sustain improvements

Project Leads:

  • Kane Sullivan– Deputy Division Operations Director & Days Matter Programme Lead
  • Salah Albuheissi – Urology Clinical Lead
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