Bowel Screening Programme: How Practice Nurses Support Participation

1. NCL Practice Nurse & HCA session – bowel screening 19/10/16

2. Bowel screening programme • Screening pathway • The role of GP practice in supporting patient participation • Endorse NHS bowel screening and support • What we will cover…

3. Bowel cancer screening programme..

4. NCL Bowel Cancer screening coverage data December 2015

5. It is the person’s choice whether to take part, but you can help them make that decision to participate or not, by making sure everyone is aware of the programme, knows the benefits as well as harms and any barriers to participation are minimised. • Key Point:

6. The Screening Pathway

7. FOBt Kit

8. Difficulty in completing the test • Unable to catch sample • Don’t understand the test • Unsure about who to call to arrange bowel screening • Procrastinating when the FOB test /appointment letter comes through • Worried about finding cancer • Low perceived risk of getting bowel cancer • There are cultural barriers • Feeling disgust about the test • Not understanding that they have to do the test more than once • Practice staff are unsure about who isn't completing the FOB test • People with learning disabilities typically need support from carers to understand and do the test, so uptake is much lower, BOTH need support • Barriers

9. Methods

10. What can you do to support your practice population?

11. Practical tips TRAINING Provide training to all of your staff KNOW THE TEST Being familiar with the FOBt test kit, can help practice staff explain it to patients. DISPLAY SCREENING INFORMATION Information can be displayed in the practice to alert people to bowel screening SIGN UP TO RECEIVE ELECTRONIC RESULTS These are available for bowel cancer screening and can be requested from the Bowel Cancer Screening Hub. Automatically READ coded. USE PRACTICE DATA You could check that the contact details of people aged 60 and over are accurate Consider checking how your practice’s uptake and coverage compares with local and national averages.

12. GP ENDORSEMENT For details of more interventions see Cancer Research UK’s Evidence and Intelligence Hub: http://www.cancerresearchuk.org/health-professional/early-diagnosis-activities/bowel-screening-projects-and-resources/evidence-on-increasing-bowel-screening-uptake

17. What works well? • What doesn’t work so well and why? • What could we do? What are we going to do (first)? • What are we doing?

18. ‘Bowel Screening can detect the invisible early signs of bowel cancer’ We can help people to understand and undertake screening by helping them to break some of the common barriers down. Many people will benefit from being shown how to use the kit. • Key Points:

19. Bowel Screening

20. Initiatives in London • The Bowel Screening Hub started sending GP Endorsement letters from June 2016 following agreement with practices. The GPE ASCEND trial showed that this low-cost approach led to an overall increase in screening uptake • Enhanced reminder letterswere introduced to the bowel screening programme in April 2016. The ASCEND trial showed that this intervention increased uptake. The increase was greater in more deprived socio-economic groups. • For more information contact Transforming Cancer Services Team London - secsu.tcstlondon@nhs.net For details of more interventions see Cancer Research UK’s Evidence and Intelligence Hub: http://www.cancerresearchuk.org/health-professional/early-diagnosis-activities/bowel-screening-projects-and-resources/evidence-on-increasing-bowel-screening-uptake

21. Bowel Scope Date of roll out of bowel scope Camden & Islington CCGs – commencing January 2017 Barnet & Haringey CCGs – commenced 2015,completion date TBC Enfield CCG – commencing July 2017

22. FIT The national screening committee has recommended that FIT replaces gFOBt. Use of this simpler and more accurate test is likely to begin in Spring 2018

23. THANK YOU Christine Harding CR-UK Facilitator Christine.harding@cancer.org.uk 07826 537210