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Faster cancer diagnosis in Stirling? Local GP explains what new service means for patients

We asked Dr Jonathan Begley, clinical lead for RCDS at Forth Valley Royal Hospital, how the new service works and why it's been implemented.

Dr Jonathan Begley, left, working at the new RCDS clinic.
Dr Jonathan Begley, left, working at the new RCDS clinic. Image: NHS Forth Valley.

NHS Forth Valley announced a new “rapid cancer diagnostic service” in May 2025.

But what is the service, how does it work, and what does it mean for patients in and around Stirling?

I spoke to Dr Jonathan Begley, a Stirling GP and the clinical lead for the RCDS, to find out everything you need to know about the service.

What is a Rapid Cancer Diagnostic Service?

A rapid cancer diagnostic service, Dr Begley explains, is a “fast track” referral option for patients with “vague and non specific symptoms that are suspicious of cancer”.

Dr Jonathan Begley and colleague Dr Ingin Phyu Phyu.
Dr Jonathan Begley and colleague Dr Ingyin Phyu Phyu. Image: NHS Forth Valley.

As a GP himself at Viewfield Medical Practice, Dr Begley understand how much anxiety the question of cancer can cause patients.

Just how ‘rapid’ is it?

“Our target is for patients to have received an outcome within 21 days from the point of referral by their GP or ANP,” says Dr Begley.

There are three possible outcomes:

  • Nothing significant is detected and no major diagnosis is made. The patient is discharged back to their GP.
  • No cancer is identified but results indicate something that requires further investigation. The patient is referred to a relevant clinician.
  • Cancer is identified. The patient is referred to an appropriate specialist, and both patient and their primary care doctor are kept informed of the process.

What happens if I’m referred to the RCDS?

“Before referral patients will have a specific set of blood tests sent and their urine dipped,” explains Dr Begley.

“The RCDS team arrange for patients to attend the clinic, with appropriate investigations also requested.”

These investigations will usually consist of a CT scan, but could include other types of scan such as ultrasounds.

A patient undergoing a blood test.
A bundle of specific blood tests will be sent for patients being referred to the RCDS. Image: Shutterstock.

The RCDS moves too quickly for appointment letters to be posted, so all communication will be done via phone or email.

This means it’s important for patients to check their GP holds up-to-date contact details.

“It should be the same person contacting the patient each time throughout their time with the service,” explains Dr Begley.

Why implement an RCDS in Forth Valley?

The first Rapid Cancer Diagnostic Service was launched in 2021.

The idea was to rapidly arrange key tests to either rule out or confirm cancer, instead of having patients be referred sometimes several times for each different test.

This is important as so much of cancer treatment relies on early detection.

A patient undergoing a CT scan as a hospital worker looks on.
A CT scan is one of the most common tests used by the RCDS.

And so far it seems to be working.

A 2024 study found that more than one in 10 patients seen by RCDSs across Scotland had been referred for cancer treatment, “helping to speed up treatment and improve outcomes”.

It also means that people with “vague” symptoms “benefit from the same infrastructure as those with symptoms that point to a particular part of the body”, Dr Begley explains.

What are ‘vague, suspicious’ symptoms?

The NHS Scotland Centre for Sustainable Delivery cites “new unexplained weight loss”, “persistent nausea” and “extreme fatigue” as examples of symptoms primary care providers would be looking out for.

Dr Jonathan Begley and Dr Ingin Phyu Phyu study data on a computer screen.
Dr Jonathan Begley and Dr Ingyin Phyu Phyu at the RCDS clinic. Image: NHS Forth Valley.

However, Dr Begley clarifies that: “The symptoms we’re talking about are quite common and GPs or ANPs would consider each patient’s unique context before deciding that a referral needs to be made.”

Why doesn’t NHS Tayside have a rapid cancer diagnostic service?

Six health boards across Scotland have a Rapid Cancer Diagnostic Service, including NHS Fife.

Notably, NHS Tayside is not one of those six.

But a spokesperson for NHS Tayside said: “We are pleased to say that in Tayside, our primary care services have had direct and open access to diagnostic tests such as laboratory, imaging and endoscopy requests for more than six years.

An aerial view of Forth Valley Royal Hospital in Larbert.
Forth Valley Royal Hospital in Larbert serves Stirling, Clackmannanshire and Falkirk. Image: Shutterstock.

“For our patients, this means that NHS Tayside’s existing pathway already provides many of the benefits that a Rapid Cancer Diagnostic Service (RCDS) could offer.”

Conversation