Supporting people with learning disabilities through flagging in the Bowel Cancer Screening Programme Julie Tucker – North East and Cumbria Learning Disability Network, project manager Phil Kelly – North East Bowel Cancer Screening, hub manager

Why is it important? Higher rates of mortality and morbidity Proportionally higher rates of gastrointestinal cancer Significantly lower uptake rates across all screening programmes Those with cancer are less likely to: be informed of their diagnosis and prognosis; be given pain relief; be involved in decisions about their care to receive palliative care

Bowel screening Bowel screening using FOBt Invites men and women age 60–74 Invited every 2 years Home test kit Nationally dictated invite letter

Bowel screening flagging project Developed a pathway that; identified, flagged and offered support to people with a learning disability prior to point of invite to the bowel screening faecal occult blood test (FOBt). This enables individually tailored work to support people with a learning disability in making a choice about participation and support through the screening process if required.

The flagging process GP practice - Gain consent to share information through enhanced annual health check or other consultation Annual information request from BCSP hub to GP’s - All individuals that consented to information sharing aged 53-74. BCSP hub - Complete upload of information provided by GP practice into additional care needs notes. BCSP Hub - Prior to pre invite letter check additional care needs note. Information shared with community learning disability team. CLDT Community learning disability team - contact individual and offer support.

South Tyneside The project was initially tested in South Tyneside. full year 1 results from May 2016 to June 2017. South Tyneside consists of 28 GP practices, with a total population of 148,700. Covered by; the North East bowel cancer screening hub, the South of Tyne bowel cancer screening centre and South Tyneside CLDT.

The results – South Tyneside 7 209 64

The results – CLDT, South Tyneside

The results – BCSP, South Tyneside

Roll out South Tyneside May 16 North Tyneside May 17 Northumberland June 17 Darlington, Hartlepool/Stockton July 17 South Tees Gateshead Sept 17 Sunderland North Durham/DDES Newcastle  

Future work Bowel scope FIT

The FIT kit The FIT kit consists of a small plastic bottle containing a stick with a grooved tip. The stick is joined to the lid of the bottle. The sample is collected by scraping the tip of the stick along the bowel motion so that the grooves are covered. The stick is then returned to the bottle which contains a liquid to preserve the sample. The bottle is clicked shut and can then be safely posted back to the screening hub.

Which one?

How is FIT different from gFOBt? Potential for tailored screening?