Fast-tracked and optimised: The impact of a one-stop lung cancer clinic on patient outcomes.

Introduction: Patients with resectable early-stage lung cancer who are at higher risk from thoracic surgery often face complex pathways to make a treatment decision, resulting in negative outcomes. The solution: The Greater Manchester One-stop Lung Cancer Clinic (GM-OSLCC) provides a multidisciplinary service of thoracic surgeons, anaesthetists, clinical oncologists, physicians, specialist nurses alongside prehabilitation, tobacco dependency and frailty specialists to support treatment decisions in a single clinic visit. Outcomes were compared between a pre-implementation cohort (n = 94) and a post implementation cohort (n = 114). Outcomes: The median time from referral to decision to treat was reduced from 20 days (interquartile range (IQR): 13-32) to 4 days (IQR: 3-8, p ≤ 0.001). The GM-OSLCC increased the uptake of prehabilitation (p = 0.036), frailty interventions (p < 0.001), tobacco dependency treatment (p < 0.001) and malnutrition interventions (p < 0.001). The average number of outpatient clinic visits reduced from 2.4 to 1 and 12-month mortality reduced from 12.8% to 3.5% (p = 0.013). Discussion: This one-stop model of care has delivered significant pathway improvements and increased the uptake of optimisation interventions, leading to significantly reduced 12-month mortality.