Days Matter: Improving Urology Cancer Pathways at Salisbury NHS Foundation Trust

By Penny Heaton | October 22, 2025

The Challenge

Salisbury NHS Foundation Trust (SDHFT) faced several challenges in its urology cancer pathway. There weren’t enough local anaesthetic trans perineal (LATP) biopsy appointments, and delays in lab results (histopathology) were slowing down diagnoses. Staffing shortages and limited space in the Urology Centre added further pressure. These issues meant longer waits for patients and more stress for clinical teams trying to make timely decisions about suspected urological cancers.

Multidisciplinary team (MDT) meetings, where specialists come together to discuss cases, had grown too large and time-consuming. This was causing delays in moving patients forward in their care.

The Approach 

To tackle these problems, the Trust has taken several steps:

  • Expanding Biopsy Capacity: A clinician is now training to carry out LATP biopsies, helping spread the workload. A new clinical fellow is also being recruited to boost short-term capacity. Extra space in day surgery has been secured to help with this.
  • Speeding Up Test Results: The pathology team has agreed to prioritise urgent cases for in-house reporting, while less urgent ones are sent elsewhere to avoid delays.
  • Improving Admin Efficiency: The urology team is trialling digital dictation to speed up clinic letters and reduce paperwork.
  • Streamlining MDT Meetings: The team has joined NHS England’s MDT Improvement Programme and is setting up a new process to make meetings more focused and efficient.
  • Supporting GPs: Education and feedback are being provided to help GPs make better referrals. Some advice requests are now being converted directly into urgent cancer referrals to avoid delays.

What Does This Mean for Patients and Staff?

For patients, these changes mean:

  • Faster access to biopsies and test results
  • Quicker decisions about their care
  • Less waiting and uncertainty

For staff, it means:

  • More efficient use of time and skills
  • Less admin burden
  • Better teamwork and morale

Impact to Date 

Progress is well underway:

  • A named trainee is in place for the non-medical LATP service
  • A clinical fellow is being recruited
  • Day surgery space has been secured
  • Urgent histology cases are now prioritised in-house
  • Digital dictation is live
  • Work is ongoing to improve how cystoscopy results are recorded
  • MDT meetings are being streamlined to focus on the most important discussions
  • GP engagement is active, with better triage of referrals already happening

Next Steps 

The Trust plans to:

  • Launch the non-medical LATP service next year
  • Finalise use of day surgery space while exploring longer-term options
  • Complete the move to digital cystoscopy reporting
  • Embed MDT streamlining into routine practice
  • Monitor patient and staff feedback to keep improving
  • Continue GP education and share learning across the SWAG Cancer Alliance

Project Leads:

  • Emilia Scutt, Cancer Manager, Salisbury NHS Foundation Trust;
  • Jonathan Borwell, Urology Clinical Lead, Salisbury NHS Foundation Trust
  • Max Johnston, Urology Clinical Lead, Consultant Urologist, Salisbury NHS Foundation Trust
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