As part of the NHS Cancer Long term plan to diagnose cancer at an earlier stage, more ICBs are being asked to review their 2WW cancer pathways and develop 2WW Non-Specific Symptom pathways at the same time as opening more GP direct access to imaging. This presentation covers the various options GPs have when they are thinking about a possible cancer in a patient, it will showcase models and clinical pathways that have been launched in the West Midlands Region as well as giving an update on the development of community diagnostic centres. The spectrum of concern about a cancer is different in each patient. Sometimes you are absolutely certain a patient has cancer, other times you are simply following the current guidelines, or you think it is a possibility that you need to rule out as well as finding it unexpectedly at times. All these sceneries require cancer referral pathways into the system which is explored in more detail.