Safety recommendation
National Institute for Health and Care Excellence (NICE)
HSIB recommends that the National Institute for Health and Care Excellence reviews its current safety netting advice to healthcare professionals with respect to the investigation of possible lung cancer. The wording of the advice should be amended as required to make it clearer what should be offered to patients with ongoing, unexplained symptoms who have had a negative chest X-ray.
Response
National Institute for Health and Care Excellence (NICE)
Following consideration of the Healthcare Safety Investigation Branch’s report, the National Institute for Health and Care Excellence (NICE) will update its guideline on suspected cancer: recognition and referral [NG12]. The update will review the current safety netting advice, which highlights the possibility of false-negative results for chest X-rays, and the diagnostic pathway for people with ongoing, unexplained symptoms who have had a negative chest X-ray.
Action: Commission an update of NG12. The update will be commissioned and scheduled into the guidelines work programme considering NICE’s existing workload and agreed priorities.
Action: Update NG12, to include a review of the current safety netting advice given in recommendation 1.15.1 and the diagnostic pathway for people with ongoing, unexplained symptoms who have had a negative chest X-ray. In line with NICE’s established processes, a number of people are involved in the development of clinical guidelines (see section 1.5 of developing NICE guidelines: the manual [PMG20]). The update will follow NICE’s established processes and methods S405for updating guidelines (see chapter 14 of developing NICE guidelines: the manual [PMG20]).
Response received 10 January 2022.
Safety recommendation
NHSX
HSIB recommends that NHSX, in collaboration with relevant stakeholders such as The Royal College of Radiologists and The Society and College of Radiographers, develops guidance to support independent benchmarking and validation of artificial intelligence algorithms for the identification of lung diseases such as cancer.
Response
NHSX
We are happy to lead on one of HSIBs recommendations. To do this, it would take approximately 6-9 months to deliver by standing this up as a work programme, with a nominated lead. We would therefore require £50,000 (approximately) to cover the costs for resourcing, etc. As next steps, we will reach out to The Royal College of Radiologists and The Society and College of Radiographers, to understand who is leading on this request at their end and suggest a collective response to HSIB.
Response received 25 January 2022.
Safety recommendation
National Institute for Health Research (NIHR)
HSIB recommends that the National Institute for Health Research assess the priority, feasibility and impact of future research to address whether low-dose computed tomography (CT) is clinically and cost-effective for the diagnosis of lung cancer in symptomatic patients seen in primary care and consider the most appropriate way of building up the evidence base on this topic.
Response
National Institute for Health Research (NIHR)
Response due 23 June 2022.