Improving Cancer Outcomes in Camden

1. Improving Cancer Outcomes in Camden Dr Lucia Grun 19 March 2014

2. International Cancer Benchmarking Partnership: 5 year relative survival, patients diagnosed 1995-2007: Coleman et al, Lancet 2011

3. International Cancer Benchmarking Partnership: 5 year relative survival, patients diagnosed 1995-2007: Coleman et al, Lancet 2011

4. Five year survival of common cancers diagnosed • Early versus late

5. Camden-specific statistics… • Directly standardised mortality rate aged under 75 for all cancers, Camden, 1993-2011 • Source: Health and Social Care Information Centre, 2013, NB data for 2009-11 are provisional at the time of publication.

6. Camden-specific statistics… • The reduction in Camden’s cancer rates has been faster over the past 10 years (27%) than England (22%) or London (25%) • May relate to greater than average reduction in numbers of smokers in Camden • In Camden, a higher proportion of people are diagnosed at stage 1 (34%) compared to neighbouring boroughs and the London average. • Camden also has a significantly higher proportion of cancers diagnosed at stage 4 (late) compared to the London average Camden Joint Strategic Needs Assessment 2013, Camden Council http://www.camden.gov.uk/ccm/content/social-care-and-health/health-in-camden/joint-strategic-needs-assessment-2012/chapter-16-cancer.en?page=3

7. National Patient Experience Survey for all cancers Question 64: Practice staff definitely did everything they could to support patient Data Source: National Cancer Patient Experience survey

8. 3 year funded project Camden CCG and London • Cancer • Delivered through other workstreams

9. Improving outcomes for Camden patients • Improve earlier diagnosis of cancer • Developing educational opportunities • Online learning package • Integrate results of recent GP questionnaire • Linking into national awareness campaigns • Reflection on current practice through various methods • Best Commissioning Pathways from NHS England • Improve communication • Interface between primary and secondary care • Facilitate connections between practices and CCG • London Cancer as a way to support this • Improve pathways for patients who present late • Learning from the A&E Audit

10. Earlier Diagnosis – Practice based • Encourage stronger links into national awareness campaigns • Awareness of key messages • Available leaflets and promotion in practices • Access to appointments • Patient perceptions • Uptake in screening programmes • Cervical • Bowel • Breast

11. Earlier Diagnosis - Communication • Education of reception staff • Appropriate use of 2ww referral between primary and secondary care • Creating a low risk but not no risk culture

12. Earlier Diagnosis - Reflection • Significant event analysis • Audit of past cancer diagnoses • Understand patient journey and route to diagnosis • Upcoming audit • Sharing learning within practices and localities • Best practice and insights across Camden • Using practice profiles • Available at today’s event • MacMillan Risk Assessment Tools

13. Best Practice Pathways for early detection

14. Numbers of ovarian cancers detected in a theoretical cohort of 100,000 with symptoms consistent with ovarian cancer presenting to primary care Assumed prevalence of undiagnosed ovarian cancer is 0.23% in women with such symptoms- total numbers of ovarian cancer cases is 230 • Source: Transforming Cancer Services for London, Best Practice Commissioning Pathway for the early detection of ovarian cancer , NHS England