# A legislated, publicly reported 28-day standard from urgent referral to diagnosis

Source: https://onco.cc/ideas/idea-acc-28-day-diagnosis-standard/  
OnCo record `idea-acc-28-day-diagnosis-standard` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Set a legal limit: anyone referred with suspected cancer should be told within 28 days whether they have it. Publish how every hospital performs each month.

## Summary

England's Faster Diagnosis Standard requires that 75% of patients referred urgently are told they have cancer or do not within 28 days, with monthly public reporting by trust. Whatever the debate on the threshold, the combination of a defined interval, a named responsible organisation, and public data has focused management attention on diagnostic pathways. Most countries have no equivalent. The proposal is to adopt and adapt it, with the threshold set by local capacity and tightened over time.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Health systems introducing a published diagnosis-interval standard will reduce the 90th-percentile referral-to-diagnosis interval by at least 30% within three years.
- Rationale: Public reporting of waiting times has repeatedly changed hospital behaviour where the measure is simple and attributable; the diagnostic interval is both.
- Proposed test: Compare interval distributions before and after introduction in an adopting jurisdiction, and against a neighbouring system without the standard.
- Maturity: being-tested-at-scale
- Actor: policy

## Sources

- NHS England Faster Diagnosis Standard (archived copy): https://web.archive.org/web/20251231165538/https://www.england.nhs.uk/cancer/faster-diagnosis/

## Connected records

- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/)

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