Dr Katie Elliott CRUK strategic GP Macmillan GP with NE ampC Learning disability Network Assistant Clinical Lead Northern Cancer Alliance NICE NG12 Suspected Cancer Recognition and referral ID: 1040931
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1. More than a 2WW referralDr Katie ElliottCRUK strategic GPMacmillan GP with NE &C Learning disability Network Assistant Clinical LeadNorthern Cancer Alliance
2. NICE NG12 Suspected Cancer: Recognition and referralIssued in June 2015Identify more cancer at an earlier stagePPV 3%Increased emphasis on early referral/ direct to test in primary care
3. Information and Support for patients and their familiesCollaborating to improve cancer care
4. Regional 2WW formsRegionally agreed - expert advisory groups/ Cancer in the community – primary care input Integrated into GP clinical systemsEMIS – load direct (except in Newcastle and Gateshead where resource publisher is )System one - join DCS organisational group ( can save editable version in S1)AimsReduce variationImprove quality of referral informationFacilitate straight to test pathwaysImprove patient experienceCollaborating to improve cancer care
5. Straight to test vs Direct accessCollaborating to improve cancer care
6. Review feedbackIn general GPs are using the forms In secondary care, lots of inappropriate information coming through but also incomplete information about the referral. Variability of who is filling in the forms is contributing to incomplete information. Secondary care asking all the time for mandatory fields because of incomplete information. PERFORMANCE STATUS, BLOOD TESTS often missingSignificant information governance risk because of the merged consultations. This option was removed from S1 forms last year and has now been removed from EMISCollaborating to improve cancer care
7. Review and improvementsCollaborating to improve cancer care
8. Performance statusEssential to safely book straight to testClinical informationCollaborating to improve cancer care
9. ResultsCollaborating to improve cancer care
10. Head and NeckCollaborating to improve cancer care
11. SkinCollaborating to improve cancer care
12. ColorectalCollaborating to improve cancer care
13. UrologyCollaborating to improve cancer care
14. Upper GICollaborating to improve cancer care
15. ChallengesOld paper formsOld electronic formsClinician / admin teams understanding the role of the 2ww formClinician behaviour Patient behaviour – DNA ( use of patient information leaflets)Variation in booking on eRS – actual vs virtual / defer to provider/ faxHow the secondary care systems work to handle the referral documentsSafety nettingCollaborating to improve cancer care
16. Northern Cancer Alliance 2WW formsWatch out for the new NCA forms and let the clinical and admin teams know.The RED boxes on the forms indicate where information is requiredUpper / Lower GI/ lung/ head and neck/ prostate pathways rely on the accuracy of the information on the forms to be able to book straight to test for CT/ colonoscopy/ MRI. Clinical criteria – this has changed for HEAD and NECK and is now closer to NICE guidance. Upper GI - new hyperlink on form to advice for conservative management of low risk sx COLORECTAL - qFIT is included but is not available yet - COMING SOON UROLOGY – MRI exclusion criteria are included to facilitate the new PROSTATE pathwayInformation to patients – PIL/ Easy readPerformance status – should be completed by the referring clinician . This is essential to safely book direct to test pathwaysClinical narrative – must all be visible in the red box ( the box does not expand)Blood tests – must be taken on the day/ before the day the referral is sent Accessible information – make sure this is completeRemove inappropriate PMH Seek Support from your local CRUK facilitatorDO NOT let incomplete referrals leave your practice
17. Implementation and Support for 2WW formsNECN/ Cancer Alliance website http://www.northerncanceralliance.nhs.uk/pathway/early-diagnosis/supporting-primary-careNICE website http://nice.org.uk/guidance/ng12CRUK website for health professionals : http://www.cancerresearchuk.org/health-professional/learning-and-development-toolsClinical queries please contact katieelliott@nhs.net or your local cancer lead CRUK primary care engagement facilitator via http://www.northerncanceralliance.nhs.uk/pathway/early-diagnosis/supporting-primary-careHelp with EMIS or System One or joining the DCS Group contact the NECS Training Team on 03005550340Collaborating to improve cancer care
18. Working togetherCollaborating to improve cancer careThank you