Costs and benefits of a one stop clinic compared with a dedicated breast clinic: randomised controlled trial.

OBJECTIVE To determine the cost to the NHS and the impact on anxiety of a one stop clinic for assessing women with suspected breast cancer. STUDY DESIGN Randomised controlled trial. PARTICIPANTS Women aged 35 or over referred with a breast lump. STUDY SETTING Teaching hospital, north west England. INTERVENTIONS Women were randomly allocated to attend a one stop clinic or a dedicated breast clinic. OUTCOME MEASURES Reduction in mean anxiety from baseline at 24 hours after the first visit and at 3 weeks and 3 months after diagnosis; mean cost per patient. RESULTS 670 women were randomised. Compared with women who attended the dedicated clinic, patients attending the one stop clinic were less anxious 24 hours after the visit (adjusted mean change in state anxiety _5.7 (95% confidence interval _8.4 to _3.0)) but not at 3 weeks or 3 months after diagnosis. The additional cost to the NHS of a one stop attendance was pound 32 per woman; this was largely explained by greater cytopathological and radiological staff costs. CONCLUSION One stop clinics may not be justified in terms of a reduction in short term anxiety.