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Towards earlier diagnosis of cancer. Dr Pawan Randev 6 th October 2014 p awan.randev@nhs.net. Overview. Introduction The context for Primary Care Why it matters How can you make a difference? Resources. About me. GP 3 days a week GP Trainer GP appraiser
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Towards earlier diagnosis of cancer Dr Pawan Randev 6th October 2014 pawan.randev@nhs.net
Overview • Introduction • The context for Primary Care • Why it matters • How can you make a difference? • Resources
About me... • GP 3 days a week • GP Trainer • GP appraiser • West Leicestershire CCG Cancer Lead • East Midlands SCN Cancer Lead • Work with 2 associate GPs and manager
Cancer outcomes lag behind similar health economies Coleman MP et al, Lancet 2011;377:127-37
Why is it so difficult? • Patient factors • Awareness – mentioning symptoms • Patient understanding • Symptoms can be vague • Co-morbid conditions (lots!) • Polypharmacy • Patient fear • Male/female denial • Continuity of care?
Why is it so difficult? • For Professionals: • More than 2/3 problems per consultation • More than 6 medications • Older patients (range of normal) • Fear of cancer – the google patient • Cancer is a small numbers game • Continuity of care – works both ways! • Busy professionals...getting busier!
How can you make a difference? • NICE Guidance – update in 2015 • 2 week wait referral forms • Clinical Decision support tool • SEAs • Appraisal • Audit • Staff Training • Understanding Patient Experience • Flexi Scope screening • All resources here http://tinyurl.com/kl5ctky • “HEEM ICA” into Google
Have you ever had a Cancer SEA? • Has this been discussed at practice SEA meetings? • Have you had a near miss? • Have you picked up a cancer that was missed by others? • How many patients fear cancer? • Do you have a structured approach to recording 2 week wait referrals?
New Cancers diagnosis audit • Developed by RCGP • National audit 2010/11 • Excel tool • Easy to complete –honest!! • Downloadable • Tested on over 16,000 cancer journeys • Strictly a survey until standards/criteria set and re-audit
Cancer Awareness Toolkit • On Line resource for GP staff • Receptionists, attached staff, social care • Pharmacists • Created by Cumbria Cancer Network • Can form part of induction for staff or bring up at appraisal or at practice learning events