By Melanie Costin, Director of Patient Engagement & Support and Interim Chief Executive.
When I agreed to represent Fight Bladder Cancer on the NHS England Timed Urology Diagnostic Pathway, I thought it might be a chance to wave the flag for patients while quietly sipping my tea in the background. Instead, I found myself deep in the trenches of clinical guidelines, policy debates, and the occasional existential question about urine samples.
Now that the pathway is published, I’m proud to say the effort was worth it. You can read it at https://www.england.nhs.uk/longread/implementing-timed-urology-cancer-diagnostic-pathway-bladder-penile-renal-and-testicular/
The Role of a Charity Voice
The clinicians, radiologists, and oncologists all spoke their own clinical languages. My job was to ensure patients remained at the heart of every discussion.
Sometimes this meant waving a metaphorical red flag when the “ideal pathway” didn’t reflect the messy realities of real life. What if the person struggles to travel? What if English isn’t their first language? What if they’re so anxious about their symptoms that the prospect of yet another test feels insurmountable? These weren’t just hypotheticals; they were the realities I brought to the table, informed by conversations with patients like me every day.
The Wins
The focus on “one-stop clinics” – where people can have tests and consultations in a single visit – is a significant victory for people affected by bladder cancer. It reduces the endless cycle of appointments and the accompanying emotional strain. It’s also a leap toward the Faster Diagnosis Standard, ensuring that more people hear “cancer ruled out” or “cancer diagnosed” within 28 days.
Equally gratifying was the inclusion of Clinical Nurse Specialists and pathway navigators. These professionals don’t just guide people through the maze of referrals and diagnostics; they provide emotional support and often become lifelines for people navigating terrifying unknowns.
The Challenges
Balancing ambition with practicality was no small feat. Everyone agrees that faster diagnosis saves lives, but achieving this within the complexities of the NHS requires more than good intentions. It demands better infrastructure, smarter triage systems, and, frankly, more hours in the day for already overstretched clinicians.
There were moments of tension, like debates over how to manage people with non-visible haematuria or whether timelines should be sacrificed for thoroughness. But it was heartening to see how much the entire group cared – whether about reducing referral-to-treatment times or ensuring that every person receives compassionate care.
The Bigger Picture
This pathway isn’t just about efficiency; it’s about giving people their lives back, even during diagnosis. Reducing waiting times means less time spent in limbo and more time focusing on what truly matters: health, family, and the future.
The NHS England Timed Pathway may not solve every challenge overnight, but it’s a significant step forward. For every person who avoids weeks of waiting, for every clinician who sees a clearer process, and for every loved one who gets answers sooner, this work matters.
Final Thoughts
Being part of this project reminded me why I joined Fight Bladder Cancer in the first place: to make a tangible difference in patients’ lives. Representing the charity was about making sure the patient voice echoed through every decision.
And yes, I still have flowchart-induced nightmares – but I’d do it all again.
Melanie Costin
Director of Patient Engagement & Support and Interim Chief Executive
