Primary care engagement Programme CRUK Primary care engagement Programme EARLY DIAGNOSIS AND GOOD PATIENT CARE: THE EVIDENCE 15TH November 2014 Tomas EDGE Welcome Overview of the session – setting the scene for the important bit which is the SEA workshop It will be brief

The Good News Cancer survival rates are improving Screening programmes help prevention and early detection You DO a great deal and CAN improve survival and health Teamwork key to coordination of care We are here to help!

Overview of cancer in Liverpool Incidence significantly higher than England. 3 top cancers for men: lung (20.3%), prostate (18.7%), bowel(13.3%). 3 top for women: breast (25.8%) lung (19%), bowel (9.2%). Liverpool has 200 more deaths per 100,000 than England.

The Gap– e.g. Lung cancer

Mortality Forecast (Liverpool) Still need to do more

Routes to Diagnosis: NB emergency have worse prognosis

Routes to Diagnosis- lung cancer

2WW Referrals High conversion rate implies an efficient use of 2ww pathway High detection rate implies fewer patients being diagnosed by slower routes, i.e routine referrals and emergencies High conversion rate coupled with high detection rate demonstrates good clinical practice Low conversion and high detection might mean overuse of 2ww pathway High conversion but low detection might mean underuse of the 2ww pathway Low conversion and low detection, poor at case selection? (Implies poor clinical practice)  Detection Rate Article in the BJGP with contributions from the RCGP and the National Clinical Director for Cancer Nationally!! In the article it showed the relationships between conversion rate and detection rate SO What should we be looking for Next 3 slides illustrate the variation across Western Cheshire Conversion Rate

What can you do? Encourage Screening: Share insight – then they will see..... Share knowledge – then they will know..... Share skills – then they will act.... Scare then – then they will change...... After Miller WR (2004) Promote healthy lifestyles Encourage Screening: Encourage people to present earlier Recognise symptoms/ signs/risks + (RATs) Investigations and Referrals Robust systems- no gaps! Reflect and review

Prevention “in the last 5 years, more than 750,000 cancers in the UK could have been prevented”

Encourage Screening 60% target (i.e.11.4% Increase): If Liverpool reached national 60% target (i.e.11.4% Increase): 54.4 more FOB Positives 21.76 more pre cancerous polyps 5.44 more cancers detected early Big opportunity to address health inequalities

Early detection: 2 great tools: RCGP Audit Tool and Practice Profiles RCGP: Dozens of mini significant event analyses Allowed GP practices to benchmark referral rates against others Allowed clearer picture of referral patterns Helped with service redesign Helped lead GPs to focus on areas of greatest need with evidence to back this up Profiles: Allowed comparison with previous years

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CRUK Primary Care Programme Supporting clinicians, CCGs, commissioners, public health to prevent & detect cancer earlier in your community

Together we can make a difference

Thank You cruk.org Tomas Edge – Senior Primary Care Engagement Facilitator Tomas.edge@cancer.org.uk Tel: 07733 451031