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Norway introduced cancer patient pathways (CPPs) in 2015. CPPs are standardised patient pathways, based on current guidelines for cancer diagnostics and treatment. The aim is to speed up patient assessments and start of treatment and minimise waiting times, in order to make the assessment period as predictable as possible. Each CPP are divided into phases, and each phase should be completed within a defined time period. The aim of this paper is to describe and discuss how healthcare professionals work to realise the objectives of the CPPs and how they reflect upon them as tools for achieving predictable and secure cancer care. The paper departs from an ongoing study (2017-2020) investigating the introduction of CPPs in Norway. The study has a qualitative cross-sectional design and focuses on four CPPs: breast-, prostate, and lung cancer, and malign melanoma. Data are mainly collected through interviews. The study setting is four hospitals, and study participants are hospital staff, including physicians, nurses, clerical workers and managers (N = 60). Preliminary results show that keeping the waiting times has become a major concern, and national statistics are published showing if the hospitals keep the defined time limits. From the perspective of healthcare workers, CPPs may contribute to a predictable assessment period for patients, and thereby creating a more secure experience. However, predictability and security rest on patients being informed about receiving care organised through a CPP. We found that in many instances this was not the case. Our study indicates that most effort in hospitals is directed towards reducing waiting times, and we argue that publishing of statistics may be an incentive for hospitals to reorganise their resources and prioritize cancer patients before other (elective) patients. Further development of the CPPs should encourage informing and supporting patients so they can have the most predictable and secure experience as possible. Key messages Patient pathways is an incentive to reorganise resources to reach defined time limits in cancer diagnostics. Short waiting times are positive for patients, even if survival rate is not necessarily affected.

Speedy, predictable and secure cancer care? Introducing cancer patient pathways in Norway