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In early 2019 increased referrals to the Breast 2WW Service, limited radiologist capacity and the pension crisis combined to cause the 2 week wait target to fail. A multidisciplinary solution was sought. Using the Nottingham Breast Institute triage criteria and decoupling clinical and radiological assessments, patients were referred along 2 pathways; red and blue flag. Methods Patients were clinically assessed by a trained breast surgeon within 2 weeks. Red flag patients underwent standard triple assessment. The aim for blue flag patients was to undergo any necessary imaging within 10 days. In both cohorts selected patients were given a patient satisfaction questionnaire. Data from red flag clinics were obtained from cancer services. Notes were reviewed for blue flag patients. Results Data on 858 blue flag patients seen were analysed. There was no difference between satisfaction scores. Conclusions The 2WW target was regained within a month of implementing change. As long as the standard operating procedure is maintained, the triage criteria adopted were successful and reduced pressure on radiology services. Patient safety and satisfaction were maintained.

TP8.1.8 Blue flag clinics. A way to achieve a 2 week wait service in the age of plentiful referrals, radiological pressures and pension threat