Fast-track pathway cuts wait for major cancer surgery

The pathway, run by Oxford University Hospitals NHS Foundation Trust’s (OUH) Department of Hepatobiliary and Pancreatic Surgery, has reduced the average wait from around 40–60 days to 14–16 days. The unit has done around 80 fast-track procedures since becoming an established pathway in March 2025.

It is designed for patients with pancreatic or lower bile duct cancers who have developed jaundice because of a blocked bile duct and are fit to have surgery without additional treatment or preparation beforehand. Around 30% of patients undergoing a Whipple procedure across the Thames Valley Cancer Network are currently offered the fast-track pathway.

A Whipple procedure is a major operation that involves removing the head of the pancreas, along with nearby parts of the digestive system, before reconnecting the remaining organs.

These patients would usually have an additional procedure before their cancer surgery to insert a small tube, known as a stent, to help relieve the blocked bile duct.

The fast-track pathway enables some patients to proceed to their cancer surgery without first having a stent inserted, reducing the time they spend waiting for treatment and avoiding the risk of complications associated with the procedure.

The pathway supports patients across Oxfordshire, Berkshire and Buckinghamshire, with an additional Clinical Nurse Specialist appointed to support its continued development.

Phil Hammond, 74, from near Bedford, was treated through the pathway after his wife Ruth, a retired nurse, noticed that the whites of his eyes had turned yellow. He went to his local hospital, where scans subsequently found a mass in his pancreas. Tests following surgery at OUH confirmed that Phil had lower bile duct cancer.

Following rapid referral and review at the Churchill Hospital, the retired recruitment manager underwent a Whipple procedure 10 days after scans confirmed a mass in his pancreas. He spent 14 nights at the Churchill following surgery and is now making a "good and steady recovery", supported by his family.

Phil said: "The whole experience has been a bit of a roller coaster but having the diagnosis and then the operation happen so quickly meant it didn’t feel too overwhelming. I’ve always been someone who just gets on with things, so I tried to stay positive and think, 'let's get this sorted'.

"My experience of the fast-track pathway has been amazing. I was apprehensive and a little scared, particularly as this was my first ever hospital admission, but any fears I had were quickly put at ease.

"I will be forever grateful to everyone involved in my care, from the surgeons and doctors to all the nursing staff. ‘Outstanding’ doesn’t feel like a strong enough word to describe them all."

Michael Silva, Consultant Surgeon and Clinical Lead for Hepatobiliary and Pancreatic Surgery at OUH, said: "It is fantastic to see Phil recovering well following his surgery. His experience demonstrates the difference this fast-track pathway can make by helping patients get to major surgery sooner.

"Delivering this requires teams to work closely together at every stage, with rapid communication, specialist diagnostics and close coordination between our surgical and nursing teams.

"It is incredibly rewarding to see what this joined-up approach can achieve for patients."

Felicity Taylor-Drewe, Chief Operating Officer at OUH, said: "This is a really positive example of how our teams are working differently to improve care for patients and reduce the time they are waiting for treatment.

"Thank you to everyone involved in developing and delivering this pathway for their hard work and commitment to our patients.

"We know there is more to do to reduce waiting times across our services, but improvements such as this show what can be achieved as we continue that work."