1. 1 Cancer indicator trend analysis NHS Ipswich & East Suffolk CCG Summary of GP practice level cancer indicators 2010 to 2014 FINAL V1 July 2015

2. 2 Contents 03Introduction – purpose of the report 04GP Practice indicator summary GP Practice indicator summary – to be added by GP practice (optional) 05Screening indicators Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation Percentage of females aged 25–64 attending cervical screening within target period Percentage of persons aged 60–69 screened for bowel cancer within 6 months of invitation 20Two week wait indicators Two Week Wait referral ratio (indirectly age standardised referral ratio) Percentage of Two Week Wait referrals with cancer (conversion rate) Percentage of new cancer cases treated which are Two Week Wait referrals (detection rate) 35Emergency admissions indicator Rate of emergency admissions with cancer per 100,000 population Acknowledgement CCG analysis of GP Cancer Profiles by East of England Strategic Clinical Network has been produced with input from Macmillan and CCG cancer leads.

3. 3 Purpose of the report The purpose of this report is to provide a summary of the key diagnosis and referral indicators for practices across Ipswich & East Suffolk CCG. We’ve selected seven key indicators from the national GP cancer profiles https://www.cancertoolkit.co.uk/Profiles/PracticePublic/Overview. These are reviewed at CCG and practice level, highlighting how the activity rates have changed over the last five years in relation to the current national targets and recommended ranges. The key indicators are as follows: https://www.cancertoolkit.co.uk/Profiles/PracticePublic/Overview  Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation  Percentage of females aged 25–64 attending cervical screening within target period  Percentage of persons aged 60–69 screened for bowel cancer within 6 months of invitation  Two Week Wait referral ratio (indirectly age standardised referral ratio)  Percentage of Two Week Wait referrals with cancer (conversion rate)  Percentage of new cancer cases treated which are Two Week Wait referrals (detection rate)  Rate of emergency admissions with cancer, per 100,000 population We’ve left the following page blank for you to copy and past your full GP cancer profile. Please note that this report is based on a small number of practices and therefore the CCG level percentages shown are sensitive to volatile changes. The GP cancer profiles should not be used for performance management. Their purpose is to help identify areas for reflection on practice. We have produced a companion pack which gives details of information sources and improvement tools such as audit templates and cancer referral support tools which have been sent with this pack, but please contact us on the email below if you have not received it. For full details of the indicators used in this report, data definitions and guidance can be found at: https://www.cancertoolkit.co.uk/Profiles/PracticePublic/Documents https://www.cancertoolkit.co.uk/Profiles/PracticePublic/Documents If you have any further queries, please contact James Perry at england.eoescncancer@nhs.net Introduction Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit 2010 to 2014 Maps contain: Ordnance Survey data © Crown copyright and database right 2012 Royal Mail data © Royal Mail copyright and database right 2012, National Statistics data © Crown copyright and database right 2012.

4. 4 LEFT BLANK FOR GP PRACTICE PROFILE SUMMARY (OPTIONAL) Available from: https://www.cancertoolkit.co.uk/Profiles/PracticePublic/Filters https://www.cancertoolkit.co.uk/Profiles/PracticePublic/Filters

5. 5 Trend in national and CCG mean average score 20102011201220132014 England mean avg74.4%74.7%74.3%73.3%73.2% CCG/PCT 1 mean avg 80.0%79.9%79.0%78.8%78.3% Key  CCG/PCT 1 mean average CCG range — National target >70% Trend in CCG range 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards. 20102011201220132014 CCG practice min62.8%47.8%65.5%72.2%71.6% CCG practice max86.7%86.6%85.1%84.9%84.3% National target: Over 70% Key — England mean average — CCG/PCT 1 mean average — National target >70% Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation Aim to be above the national target (70%). Consider actively encouraging patients to participate in screening programmes with letters or opportunistic prompts. GPs can be influential here. Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit Definition: The number of females aged 50-70 registered to the practice screened adequately within 6 months of invitation, divided by the total number of females aged 50-70 invited for screening in the previous 12 months. Indicator source(s): Data was extracted from the NHAIS via the Open Exeter system. Data was collected by the NHS Cancer Screening Programme. For full details see: https://www.cancertoolkit.co.uk/Profiles/ PracticePublic/Documents https://www.cancertoolkit.co.uk/Profiles/ PracticePublic/Documents The Ipswich & East Suffolk CCG average for the percentage of women aged 50- 70 screened for breast cancer continues to remain above the national average and above the national target of 70%. The minimum screening rate achieved by a practice within the CCG has remained above the national target of 70% for the last two years. The Ipswich & East Suffolk CCG mean average for breast screening has continued to remain above the national average and above the national target of 70%. The maximum and minimum breast screening rate for Ipswich & East Suffolk CCG practices, decreased in over the last three years. The minimum rate has remained above the 70% national target for the last two years.

6. 6 Distribution of practice screening rates within the CCG Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation National target: Over 70% Maps contain: Ordnance Survey data © Crown copyright and database right 2012, Royal Mail data © Royal Mail copyright and database right 2012, National Statistics data © Crown copyright and database right 2012 All Ipswich & East Suffolk CCG practices achieved the 70% national breast screening target in 2013 and 2014. 100% of practices across Ipswich & East Suffolk CCG achieved the 70% breast cancer target for the last two years. The proportion of practices achieving 80% to 90% decreased in 2014. 39 of the 40 practices (98%) achieved the 80% breast screening target for the last three years. No practices failed to achieve the target for the last three years. 1 Only practices with indicator scores for all three years are included. Targets achieved for last 3 years 1 Key Targets achieved over last 3 years 3 2 1 0 N/A

7. 7 Three year profile (2012 to 2014) Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation National target: Over 70% Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13 201220132014 Practices above national target40(42)40(40)41(41) Practices above national target (%) 95.2%100.0% 55% of practices (22/40) saw an increase in the breast screening rate between 2012 and 2013. Whereas between 2013 and 2014, 68% of practices (27/40) saw a decrease. Key 2012 2013 2014 Suffolk Brett Stour Commissioning Ideals Alliance Ipswich Deben Health Group

8. 8 Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation Definition: Correlation coefficient (r) The correlation coefficient measures the strength and direction of a linear relationship between two variables. As a general rule of thumb: 0.7 to 1 or -1 to -0.7 is considered a strong correlation. 0.4 to 0.7 or -0.7 to -0.4: A moderate correlation. 0.1 to 0.4 to -0.4 to -0.1: A weak correlation. -0.1 to 1.0: No correlation National target: Over 70% Relationship between screening target and demographics There is a moderate correlation between the breast screening rate and all the deprivation indicators shown below. Moderate correlation Moderate correlation Moderate correlation Moderate correlation Moderate correlation

9. 9 Details of practice indicator scores 1/2 Key Above national target  Below national target  Increase year on year  No change year on year  Decrease year on year Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation National target: Over 70% 1 Percentage points Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83049Little St John St77.1%  76.1%  84.3%  7.2% D83061Wickham Market MC83.6%  79.7%  83.3%  -0.3% D83001Constable Country Rural MP80.6%  83.8%  81.7%  1.1% D83015Howard Hs80.3%  84.6%  81.5%  1.2% D83084The Birches MC76.5%  79.4%  81.4%  4.9% D83080Martlesham81.8%  80.7%  81.3%  -0.5% D83020Holbrook74.4%  84.9%  81.2%  6.8% D83036Church Farm79.4%  76.7%  80.7%  1.3% D83017Needham Market Country Pr82.5%  80.8%  80.7%  -1.8% D83052Lattice Barn82.0%  82.5%  80.4%  -1.6% D83044Stow Health79.9%  79.5%  80.3%  0.4% D83019Mendlesham HC77.3%  82.0%  80.1%  2.8% D83037Hadleigh HC82.2%  81.3%  80.1%  -2.1% D83057Framfield Hs79.0%  81.7%  79.8%  0.8% D83050Deben Rd76.4%  79.6%  79.7%  3.3% D83048Central82.4%  80.5%  79.4%  -3.0% D83041Debenham80.4%  77.5%  79.3%  -1.1% D83051Derby Rd81.1%   79.2%  -1.9% D83004Felixstowe Rd MP82.7%  80.2%  78.8%  -3.9% D83043Eye HC85.1%  75.2%  78.6%  -6.5% D83058The Norwich Rd78.5%  79.1%  78.6%  0.1%

10. 10 Details of practice indicator scores 2/2 Key Above national target  Below national target  Increase year on year  No change year on year  Decrease year on year Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation National target: Over 70% 1 Percentage points Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83082Walton78.1%  81.3%  78.5%  0.4% D83026Framlingham79.8%  81.8%  78.5%  -1.3% D83024Ivry St MP76.5%  80.2%  78.3%  1.8% D83615Gipping Valley71.2%  n/a  78.2%   7.0% D83007Ixworth84.1%  78.3%  77.7%  -6.4% D83079Combs Ford83.3%  79.9%  77.1%  -6.2% D83054Alderton78.9%  83.0%  76.0%  -2.9% D83008Burlington Rd79.1%  75.7%  75.8%  -3.3% D83028Leiston79.5%  81.1%  75.6%  -3.9% Y01794Ravenswood MP77.4%  74.8%  75.5%  -1.9% D83006Bildeston HC73.9%  76.4%  74.3%  0.4% D83059Barrack Lane MC70.9%  72.2%  73.9%  3.0% D83081Haven Health76.3%  73.8%  73.5%  -2.8% D83056Hawthorn Dr69.6%  72.2%  73.4%   3.8% D83046Woodbridge Rd74.9%  78.6%  73.3%  -1.6% D83074Orchard MP73.7%  75.6%  73.2%  -0.5% D83053Saxmundham HC75.6%  79.0%  73.1%  -2.5% D83039Chesterfield Dr71.0%  74.6%  73.0%  2.0% D83069Fressingfield MC84.6%  80.4%  72.0%  -12.6% D83073Orchard St MP (Blue)72.2%  74.3%  71.6%  -0.6%

11. 11 Trend in national and CCG mean average score 20102011201220132014 England mean avg75.4%75.6%75.3%74.0%74.3% CCG/PCT 1 mean avg 78.7%78.2%77.4%76.0%75.6% Key  CCG/PCT 1 mean average CCG range — National target >80% Trend in CCG range 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards. 20102011201220132014 CCG practice min67.2%66.2%65.8%63.5%62.9% CCG practice max84.8%84.0%82.7%82.6%85.0% National target: Over 80% Key — England mean average — CCG/PCT 1 mean average — National target >80% Percentage of females aged 25–64 attending cervical screening within target period Aim to be above the national target (80%). Consider actively encouraging patients to participate in screening programmes with letters or opportunistic prompts. GPs can be influential here. Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit Definition: The overall cervical screening coverage: the number of women registered at the practice screened adequately in the previous 42 months (if aged 24-49) or 66 months (if aged 50-64) divided by the number of eligible women on last day of review period. Indicator source(s): Data was extracted from the NHAIS via the Open Exeter system. Data was collected by the NHS Cancer Screening Programme. For full details see: https://www.cancertoolkit.co.uk/Profiles/ PracticePublic/Documents https://www.cancertoolkit.co.uk/Profiles/ PracticePublic/Documents The Ipswich & East Suffolk CCG mean average for cervical screening has decreased over the last five years and remains below the national target of 80% but continues to be above the national average. The range of cervical screening rates for Ipswich & East Suffolk CCG practices increased in 2013 and 2014. The minimum cervical screening rate was at its lowest level in 2014 of the last five years, similarly the maximum was at its highest. The Ipswich & East Suffolk CCG average for the percentage of women aged 25- 64 screened for cervical cancer has decreased over the last five years. The minimum cervical screening rate across Ipswich & East Suffolk CCG was at its lowest level in 2014 of the last five years, similarly the maximum was at its highest.

12. 12 Distribution of practice screening rates within the CCG Percentage of females aged 25–64 attending cervical screening within target period National target: Over 80% Maps contain: Ordnance Survey data © Crown copyright and database right 2012, Royal Mail data © Royal Mail copyright and database right 2012, National Statistics data © Crown copyright and database right 2012 6 of the 41 practices (15%) achieved the 80% cervical screening target for the last three years. 28 practices (68%) failed to achieve the target for the last three years. The proportion of practices across Ipswich & East Suffolk CCG achieving the 80% national target for cervical screening rates has decreased over the last three years. 68% of practices failed to achieve the 80% target for the last three years. The proportion of practices across Ipswich & East Suffolk CCG achieving the 80% national target for cervical screening has decreased over the last three years. The proportion of practices achieving 75% to 80% increased in 2014. 1 Only practices with indicator scores for all three years are included. Targets achieved for last 3 years 1 Key Targets achieved over last 3 years 3 2 1 0 N/A

13. 13 Three year profile (2012 to 2014) Percentage of females aged 25–64 attending cervical screening within target period National target: Over 80% 201220132014 Practices above national target13(42)8(42)6(41) Practices above national target (%) 31.0%19.0%14.6% 90% of practices (37/41) saw a decrease in the cervical screening rate between 2012 and 2013. 61% of practices (25/41) saw a decrease between 2013 and 2014. The number of practices achieving the 80% target has decreased over the last three years. Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13 Key 2012 2013 2014 Suffolk Brett Stour Commissioning Ideals Alliance Ipswich Deben Health Group

14. 14 Percentage of females aged 25–64 attending cervical screening within target period National target: Over 80% There is a moderate correlation between the cervical screening rate and all of the demographic indicators shown below, excluding the rate of cancer deaths which shows a weak correlation with the cervical screening rate. Relationship between screening target and demographics Definition: Correlation coefficient (r) The correlation coefficient measures the strength and direction of a linear relationship between two variables. As a general rule of thumb: 0.7 to 1 or -1 to -0.7 is considered a strong correlation. 0.4 to 0.7 or -0.7 to -0.4: A moderate correlation. 0.1 to 0.4 to -0.4 to -0.1: A weak correlation. -0.1 to 1.0: No correlation Weak correlation Moderate correlation Moderate correlation Moderate correlation Moderate correlation

15. 15 Details of practice indicator scores 1/2 Key Above national target  Below national target  Increase year on year  No change year on year  Decrease year on year Percentage of females aged 25–64 attending cervical screening within target period National target: Over 80% 1 Percentage points Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83007Ixworth82.0%  82.6%  85.0%  3.0% D83043Eye HC81.0%  80.8%  81.8%  0.8% D83084The Birches MC82.7%  82.6%  81.0%  -1.7% D83026Framlingham81.9%  81.4%  80.6%  -1.3% D83081Haven Health80.3%  80.5%  80.6%  0.3% D83051Derby Rd80.1%  80.5%  80.2%  0.1% D83041Debenham80.8%  79.4%  79.9%   -0.9% D83057Framfield Hs81.1%  80.4%  79.8%   -1.3% D83049Little St John St80.8%  78.6%  79.7%   -1.1% D83052Lattice Barn81.5%  80.1%  79.4%   -2.1% D83015Howard Hs79.9%  78.6%  79.0%   -0.9% D83020Holbrook80.4%  78.1%  78.8%   -1.6% D83019Mendlesham HC80.5%  79.8%  78.7%   -1.8% D83080Martlesham79.2%  78.3%  78.7%   -0.5% D83069Fressingfield MC79.8%  78.1%  78.5%   -1.3% D83615Gipping Valley80.3%  79.9%  78.0%   -2.3% Y01794Ravenswood MP79.3%  78.6%  77.9%   -1.4% D83024Ivry St MP77.8%  77.6%  77.0%   -0.8% D83037Hadleigh HC79.1%  77.0%  76.8%   -2.3% D83082Walton79.2%  77.2%  76.7%   -2.5% D83044Stow Health78.6%  77.2%  76.6%   -2.0%

16. 16 Details of practice indicator scores 2/2 Key Above national target  Below national target  Increase year on year  No change year on year  Decrease year on year Percentage of females aged 25–64 attending cervical screening within target period National target: Over 80% 1 Percentage points Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83048Central76.8%  75.3%  76.5%   -0.3% D83017Needham Market Country Pr77.2%  75.4%  76.3%   -0.9% D83061Wickham Market MC79.5%  77.1%  76.2%   -3.3% D83050Deben Rd74.4%  73.3%  76.0%   1.6% D83053Saxmundham HC76.1%  75.5%  75.9%   -0.2% D83001Constable Country Rural MP79.7%  78.6%  75.7%   -4.0% D83054Alderton77.1%  77.4%  75.1%   -2.0% D83004Felixstowe Rd MP78.3%  77.0%  75.1%   -3.2% D83028Leiston76.8%  74.3%  74.9%   -1.9% D83079Combs Ford76.9%  74.6%  74.5%   -2.4% D83039Chesterfield Dr77.8%  76.4%  74.4%   -3.4% D83036Church Farm76.5%  74.4%  73.7%   -2.8% D83006Bildeston HC78.0%  76.2%  73.1%   -4.9% D83058The Norwich Rd75.4%  73.1%    -2.3% D83056Hawthorn Dr71.6%  70.5%  71.7%   0.1% D83046Woodbridge Rd73.2%  71.6%  70.7%   -2.5% D83059Barrack Lane MC73.2%  70.9%  69.1%   -4.1% D83074Orchard MP69.7%  67.8%  65.8%   -3.9% D83008Burlington Rd65.8%  63.9%  63.4%   -2.4% D83073Orchard St MP (Blue)67.6%  63.5%  62.9%   -4.7%

17. 17 Trend in national and CCG mean average score 20102011201220132014 England mean avg55.1%57.5%55.7%58.7%55.4% CCG/PCT 1 mean avg 60.9%62.1%61.7%62.0%60.4% Key  CCG/PCT 1 mean average CCG range — National target >60% Trend in CCG range 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards. 20102011201220132014 CCG practice min37.0%40.3%42.2%44.8%50.7% CCG practice max68.1%67.7%71.2%69.2%69.1% National target: Over 60% Key — England mean average — CCG/PCT 1 mean average — National target >60% Percentage of persons, 60–69, screened for bowel cancer within 6 months of invitation Aim to be above the national target (60%). Consider actively encouraging patients to participate in screening programmes with letters or opportunistic prompts. GPs can be influential here. Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit Definition: The number of persons aged 60-69 registered to the practice screened adequately within 6 months of invitation, divided by the total number of females aged 60-69 invited for screening in the previous 12 months. Indicator source(s): Bowel Cancer Screening System (BCCS) via the Open Exeter system. Data was collected by the NHS Cancer Screening Programme. For full details see: https://www.cancertoolkit.co.uk/Profiles/ PracticePublic/Documents https://www.cancertoolkit.co.uk/Profiles/ PracticePublic/Documents The Ipswich & East Suffolk CCG mean average for bowel cancer screening has remained just above the national target of 60% and above the national average. The range of bowel screening rates for Ipswich & East Suffolk CCG practices has decreased since 2012. The minimum screening rate was at its highest level in 2014 of the last five years. The Ipswich & East Suffolk CCG average for the percentage of people aged 60- 69 screened for bowel cancer continues to remain above the national target of 60% and above the national average. The minimum bowel screening rate for Ipswich & East Suffolk CCG practices was at its highest level in 2014 of the last five years.

18. 18 Distribution of practice screening rates within the CCG Percentage of persons, 60–69, screened for bowel cancer within 6 months of invitation National target: Over 60% Maps contain: Ordnance Survey data © Crown copyright and database right 2012, Royal Mail data © Royal Mail copyright and database right 2012, National Statistics data © Crown copyright and database right 2012 21 of the 41 practices (51%) achieved the 60% bowel screening target for the last three years. 11 practices (27%) failed to achieve the target for the last three years. The proportion of practices across Ipswich & East Suffolk CCG achieving more than the 60% national target for bowel screening rates decreased in 2014. Half the practices achieved the 60% national target for the last three years. The proportion of practices across Ipswich & East Suffolk CCG achieving more than the 60% national target for bowel screening rates decreased in 2014 as the proportion of practices achieving between 50% and 60% increased. 1 Only practices with indicator scores for all three years are included. Targets achieved for last 3 years 1 Key Targets achieved over last 3 years 3 2 1 0 N/A

19. 19 Three year profile (2012 to 2014) Percentage of persons, 60–69, screened for bowel cancer within 6 months of invitation National target: Over 60% 201220132014 Practices above national target28(42) 24(41) Practices above national target (%) 66.7% 58.5% 63% of practices (26/41) saw an increase in the bowel screening rate between 2012 and 2013, whereas between 2013 and 2014 73% of practices (30/41) saw a decrease. In 2014 the number of practices achieving the 60% target dropped to 24/41 practices (59%) from 28/42 (67%) in 2013. Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13 Key 2012 2013 2014 Suffolk Brett Stour Commissioning Ideals Alliance Ipswich Deben Health Group

20. 20 Percentage of persons, 60–69, screened for bowel cancer within 6 months of invitation National target: Over 60% Relationship between screening target and demographics Definition: Correlation coefficient (r) The correlation coefficient measures the strength and direction of a linear relationship between two variables. As a general rule of thumb: 0.7 to 1 or -1 to -0.7 is considered a strong correlation. 0.4 to 0.7 or -0.7 to -0.4: A moderate correlation. 0.1 to 0.4 to -0.4 to -0.1: A weak correlation. -0.1 to 1.0: No correlation There is a strong correlation between the cervical screening rate and the deprivation indicator. The remaining demographic indicators have a moderate correlation with the cervical screening rate, except the rate of cancer deaths which has a weak correlation. Weak correlation Strong correlation Moderate correlation Moderate correlation Moderate correlation

21. 21 Details of practice indicator scores 1/2 Key Above national target  Below national target  Increase year on year  No change year on year  Decrease year on year Percentage of persons, 60–69, screened for bowel cancer within 6 months of invitation National target: Over 60% 1 Percentage points Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83080Martlesham66.6%  69.2%  69.1%  2.5% D83019Mendlesham HC71.2%  66.8%  68.8%  -2.4% D83001Constable Country Rural MP66.9%  68.2%  65.6%  -1.3% D83057Framfield Hs65.3%  62.6%  64.6%  -0.7% D83007Ixworth63.7%  68.5%  64.5%  0.8% D83052Lattice Barn63.5%  65.4%  64.0%  0.5% D83084The Birches MC64.6%  67.4%  64.0%  -0.6% D83041Debenham65.7%  64.9%  63.5%  -2.2% D83037Hadleigh HC62.4%  64.6%  63.5%  1.1% D83049Little St John St65.2%  67.9%  63.5%  -1.7% D83043Eye HC64.2%  62.1%  63.3%  -0.9% D83054Alderton66.0%  58.0%  63.2%   -2.8% D83026Framlingham65.4%  65.6%  63.1%  -2.3% D83061Wickham Market MC63.1%  63.5%  62.9%  -0.2% D83069Fressingfield MC67.4%  68.1%  62.9%  -4.5% D83082Walton60.1%  57.7%  62.6%   2.5% D83006Bildeston HC69.2%  63.2%  62.0%  -7.2% D83048Central62.1%  61.5%  61.9%  -0.2% D83044Stow Health64.5%  63.5%  61.4%  -3.1% D83615Gipping Valley61.5%  62.7%  61.3%  -0.2% D83020Holbrook61.5%  66.6%  61.1%  -0.4%

22. 22 Details of practice indicator scores 2/2 Key Above national target  Below national target  Increase year on year  No change year on year  Decrease year on year Percentage of persons, 60–69, screened for bowel cancer within 6 months of invitation National target: Over 60% 1 Percentage points Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83051Derby Rd59.0%  62.8%  61.0%   2.0% D83079Combs Ford61.6%  62.5%  60.9%  -0.7% D83017Needham Market Country Pr63.2%  63.9%  60.5%  -2.7% D83053Saxmundham HC61.4%  62.7%  59.3%   -2.1% D83028Leiston58.4%  60.3%  59.3%   0.9% D83036Church Farm60.3%  62.2%  59.2%   -1.1% D83081Haven Health55.7%  59.2%    3.5% D83015Howard Hs66.9%  62.3%  59.1%   -7.8% D83024Ivry St MP59.8%  59.4%  58.6%   -1.2% D83058The Norwich Rd61.1%  61.7%  58.6%   -2.5% D83004Felixstowe Rd MP60.0%  64.0%  58.1%   -1.9% D83008Burlington Rd55.6%  59.0%  55.6%   0.0% D83046Woodbridge Rd58.2%  59.0%  55.1%   -3.1% D83074Orchard MP55.6%  54.3%  54.8%   -0.8% D83056Hawthorn Dr53.5%  50.4%  54.0%   0.5% Y01794Ravenswood MP53.0%  54.1%  52.7%   -0.3% D83050Deben Rd55.8%  51.7%  51.9%   -3.9% D83039Chesterfield Dr55.0%  55.2%  51.8%   -3.2% D83059Barrack Lane MC52.9%  54.1%  51.2%   -1.7% D83073Orchard St MP (Blue)56.2%  49.4%  50.7%   -5.5%

23. 23 Trend in national and CCG mean average score 20102011201220132014 England mean avg100% CCG/PCT 1 mean avg n/a Key  CCG/PCT 1 mean average CCG range — Recommended minimum = 80% Trend in CCG range 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards. 20102011201220132014 CCG practice min43.8%42.1%43.3%30.6%48.4% CCG practice max138.2%154.1%151.6%110.6%113.2% Key — England mean average — CCG/PCT 1 mean average — Recommended minimum = 80% No PCT/CCG data available for this metric. Recommended minimum: 80% Two Week Wait referral ratio (indirectly age standardised) Aim to be referring higher than 20% below the England average two week wait referral rate. Practices below 80% may indicate under use of two week referrals. Practices may want to audit new cancer diagnoses against NICE cancer referral guidance. NOTE guidance changed June 2015 https://www.macmillan.org.uk/Documents/AboutUs/H ealth_professionals/PCCL/Rapidreferralguidelines.p df Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit Definition: The number of Two Week Wait referrals where cancer is suspected multiplied by 100,000 divided by the list size of the practice in question. Indicator source(s): Knowledge and Intelligence Team (East Midlands) based on Cancer Waiting Times data for England, 2012/13, held on the NHS England Cancer Waiting Times Database. For full details see: https://www.cancertoolkit.co.uk/Profiles/PracticePubli c/Documents https://www.cancertoolkit.co.uk/Profiles/PracticePubli c/Documents The minimum and maximum TWW referral ratio for Ipswich & East Suffolk CCG practices both increased in 2014. The minimum TWW referral ratio was at its highest level in 2014 of the last five years. The minimum TWW referral ratio for practices within Ipswich & East Suffolk CCG was at its lowest level in 2014 of the last five years.

24. 24 Distribution of practice TWW referral ratios within the CCG Two Week Wait referral ratio (indirectly age standardised) Maps contain: Ordnance Survey data © Crown copyright and database right 2012, Royal Mail data © Royal Mail copyright and database right 2012, National Statistics data © Crown copyright and database right 2012 Recommended minimum: 80% 15 of the 41 practices (37%) achieved the 80% recommended minimum for the TWW referral ratio for the last three years. 9 practices (22%) failed to achieve the recommended minimum for the last three years. The proportion of practices across Ipswich & East Suffolk CCG achieving more than the recommended minimum of 80% for the TWW referral ratio increased in 2014. 37% of practices achieved the 80% recommended minimum for the last three years. The proportion of practices across Ipswich & East Suffolk CCG achieving the recommended minimum of 80% for the TWW referral ratio increased in 2014. The proportion of practices achieving less than 70% increased in 2014. 1 Only practices with indicator scores for all three years are included. Targets achieved for last 3 years 1 Key Targets achieved over last 3 years 3 2 1 0 N/A

25. 25 Three year profile (2012 to 2014) Two Week Wait referral ratio (indirectly age standardised) 201220132014 Practices above recommended min.24(42)19(42)23(41) Practices above recommended min. (%) 57.1%45.2%56.1% 71% of practices (29/41) saw a decrease in the TWW referral ratio between 2012 and 2013, whereas between 2013 and 2014, 68% of practices saw an increase. 23/41 practices achieved the recommended minimum of 80% in 2014. Recommended minimum: 80% Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13 Key 2012 2013 2014 Suffolk Brett Stour Commissioning Ideals Alliance Ipswich Deben Health Group

26. 26 Two Week Wait referral ratio (indirectly age standardised) Recommended minimum: 80% Relationship between screening target and demographics Definition: Correlation coefficient (r) The correlation coefficient measures the strength and direction of a linear relationship between two variables. As a general rule of thumb: 0.7 to 1 or -1 to -0.7 is considered a strong correlation. 0.4 to 0.7 or -0.7 to -0.4: A moderate correlation. 0.1 to 0.4 to -0.4 to -0.1: A weak correlation. -0.1 to 1.0: No correlation There is a weak or no correlation between the TWW referral ratio and the demographic indicators shown below. No correlation Weak correlation Weak correlation No correlation Weak correlation

27. 27 Details of practice indicator scores 1/2 Key Above recommended minimum  Below recommended minimum  Increase year on year  No change year on year  Decrease year on year Two Week Wait referral ratio (indirectly age standardised) 1 Percentage points Recommended minimum: 80% Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83037Hadleigh HC116.8%  109.4%  113.2%  -3.6% D83046Woodbridge Rd75.9%  103.0%  110.1%   34.2% D83058The Norwich Rd91.6%  101.3%  106.6%  15.0% D83007Ixworth131.3%  102.0%  105.4%  -25.9% D83073Orchard St MP (Blue)151.6%  88.2%  102.6%  -49.0% D83008Burlington Rd115.7%  91.8%  102.4%  -13.3% D83615Gipping Valley47.3%  78.4%  97.7%   50.4% D83001Constable Country Rural MP115.8%  97.3%  94.7%  -21.1% Y01794Ravenswood MP98.7%  88.2%  94.1%  -4.6% D83059Barrack Lane MC89.8%  88.7%  93.8%  4.0% D83044Stow Health111.7%  96.6%  92.4%  -19.3% D83019Mendlesham HC118.2%  90.8%  92.3%  -25.9% D83028Leiston80.7%  72.7%  91.9%   11.2% D83054Alderton57.0%  76.8%  90.2%   33.2% D83049Little St John St98.0%  82.1%  89.1%  -8.9% D83017Needham Market Country Pr110.1%  110.6%  88.5%  -21.6% D83080Martlesham59.3%  73.0%  87.5%   28.2% D83079Combs Ford108.2%  80.8%  87.4%  -20.8% D83084The Birches MC99.3%  91.0%  86.5%  -12.8% D83036Church Farm77.1%  74.1%  85.3%   8.2% D83026Framlingham75.8%  57.3%  81.2%   5.4%

28. 28 Details of practice indicator scores 2/2 Key Above recommended minimum  Below recommended minimum  Increase year on year  No change year on year  Decrease year on year Two Week Wait referral ratio (indirectly age standardised) 1 Percentage points Recommended minimum: 80% Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83074Orchard MP83.5%  76.7%  80.4%   -3.1% D83051Derby Rd98.0%  86.1%  80.1%  -17.9% D83041Debenham88.4%  67.8%  77.2%   -11.2% D83020Holbrook75.2%  102.4%  76.3%   1.1% D83061Wickham Market MC69.1%  74.0%  76.2%   7.1% D83052Lattice Barn96.8%  71.1%  73.7%   -23.1% D83006Bildeston HC85.8%  67.2%  73.3%   -12.5% D83024Ivry St MP83.9%  82.9%  71.3%   -12.6% D83081Haven Health112.2%  77.8%  70.1%   -42.1% D83050Deben Rd43.9%  57.7%  69.9%   26.0% D83004Felixstowe Rd MP68.0%  63.0%  67.9%   -0.1% D83039Chesterfield Dr71.6%  56.7%  67.5%   -4.1% D83056Hawthorn Dr63.1%  74.4%  65.3%   2.2% D83015Howard Hs82.5%  79.5%  62.9%   -19.6% D83048Central79.2%  81.5%  62.8%   -16.4% D83043Eye HC74.2%  71.1%  59.6%   -14.6% D83057Framfield Hs84.2%  71.8%  59.0%   -25.2% D83082Walton43.3%  48.8%  54.6%   11.3% D83053Saxmundham HC50.3%  41.8%  51.0%   0.7% D83069Fressingfield MC69.2%  30.6%  48.4%   -20.8%

29. 29 Trend in national and CCG mean average score 20102011201220132014 England mean avg11.2%10.9%10.6%10.0%9.5% CCG/PCT 1 mean avg 12.2%11.8%13.3%11.5%12.6% Key  CCG/PCT 1 mean average CCG range — Recommended maximum 14% Trend in CCG range 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards. 20102011201220132014 CCG practice min5.5%7.3%6.6%6.7%7.4% CCG practice max29.4%27.3%30.4%23.6%25.7% Key — England mean average — CCG/PCT 1 mean average — Recommended maximum 14% Recommended maximum: 14% Percentage of Two Week Wait referrals with cancer (conversion rate) Aim to have conversion rate no higher than 14%. Rates above this range may indicate under use of the two week wait referral route. Consider using cancer decision support (CDS) tools to help decide whether to refer patients. NOTE guidance changed June 2015 http://www.macmillan.org.uk/Aboutus/Healt handsocialcareprofessionals/Macmillanspro grammesandservices/Earlydiagnosisprogra mme/Electroniccancerdecisionsupport(eCD S)tool.asp Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit Definition: The ‘conversion rate’, i.e., the proportion of Two Week Wait referrals that are subsequently diagnosed with cancer: the number of new cancer cases treated in 2012/13 who were referred through the two week wait route divided by the total number of Two Week Wait referrals in 2012/13. Indicator source(s): Knowledge and Intelligence Team (East Midlands) based on Cancer Waiting Times data for England, 2012/13, held on the NHS England Cancer Waiting Times Database. For full details see: https://www.cancertoolkit.co.uk/Profiles/Pra cticePublic/Documents https://www.cancertoolkit.co.uk/Profiles/Pra cticePublic/Documents The Ipswich & East Suffolk CCG mean average for the TWW referral conversion rate continues to remain below the recommended maximum of 14% but above the national average. The minimum TWW referral conversion rates for Ipswich & East Suffolk CCG practices has remained between 6% and 7% over the last five years. The Ipswich & East Suffolk CCG mean average for the TWW referral conversion rate continues to remain below the recommended maximum of 14% but above the national average.

30. 30 Distribution of practice TWW referral conversion rates within the CCG Percentage of Two Week Wait referrals with cancer (conversion rate) Maps contain: Ordnance Survey data © Crown copyright and database right 2012, Royal Mail data © Royal Mail copyright and database right 2012, National Statistics data © Crown copyright and database right 2012 Recommended maximum: 14% 12 of the 40 practices (30%) had TWW referral conversion rates below the recommended maximum of 14% between 2012 and 2014. 3 practices (8%) failed to remain below 14% for all three years. The proportion of Ipswich and East Suffolk CCG practices remaining below the recommended maximum of 14% decreased in 2014. 30% of practices remained below the recommended maximum of 14% for the TWW referral conversion rate for the last three years. The proportion of Ipswich and East Suffolk CCG practices remaining below the recommended maximum of 14% decreased in 2014 as the proportion of practices achieving 14% to 20% increased. 1 Only practices with indicator scores for all three years are included. Targets achieved for last 3 years 1 Key Targets achieved over last 3 years 3 2 1 0 N/A

31. 31 Three year profile (2012 to 2014) Percentage of Two Week Wait referrals with cancer (conversion rate) 201220132014 Practices below recommended max.21(40)32(40)25(41) Practices below recommended max. (%) 52.5%80.0%61.0% 65% of practices (26/40) saw a decrease in the TWW referral conversion rate between 2012 and 2013, whereas between 2013 and 2014, 65% of practices saw an increase. 25/41 practices remained below the recommended minimum of 14% in 2014. Recommended maximum: 14% Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13 Key 2012 2013 2014 Suffolk Brett Stour Commissioning Ideals Alliance Ipswich Deben Health Group

32. 32 Percentage of Two Week Wait referrals with cancer (conversion rate) Recommended maximum: 14% Relationship between screening target and demographics Definition: Correlation coefficient (r) The correlation coefficient measures the strength and direction of a linear relationship between two variables. As a general rule of thumb: 0.7 to 1 or -1 to -0.7 is considered a strong correlation. 0.4 to 0.7 or -0.7 to -0.4: A moderate correlation. 0.1 to 0.4 to -0.4 to -0.1: A weak correlation. -0.1 to 1.0: No correlation There is a moderate correlation between the TWW referral conversion rate and the proportion of population aged 65+. The remaining demographic indicators show a weak or no correlation with the TWW referral conversion rate. Weak correlation No correlation Moderate correlation No correlation No correlation

33. 33 Details of practice indicator scores 1/2 Key Below recommended maximum  Above recommended maximum  Increase year on year  No change year on year  Decrease year on year Percentage of Two Week Wait referrals with cancer (conversion rate) 1 Percentage points Recommended maximum: 14% Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83015Howard Hs19.9%  16.8%  25.7%   5.8% D83053Saxmundham HC30.4%  18.9%  25.3%   -5.1% D83041Debenham11.2%  15.3%  19.3%   8.1% D83043Eye HC20.2%  13.8%  18.9%   -1.3% D83048Central13.2%  7.8%  17.7%   4.5% D83052Lattice Barn13.0%  12.3%  17.1%   4.1% D83057Framfield Hs11.3%  12.1%  16.4%   5.1% D83054Alderton12.1%  14.0%  16.4%   4.3% D83074Orchard MP7.9%  8.7%  16.4%   8.5% D83069Fressingfield MC21.7%  13.3%  15.4%   -6.3% D83036Church Farm28.1%  13.0%  15.3%   -12.8% D83084The Birches MC10.5%  12.4%  14.6%   4.1% D83004Felixstowe Rd MP16.5%  16.7%  14.3%   -2.2% D83001Constable Country Rural MP11.1%  10.9%  14.3%   3.2% D83051Derby Rd11.1%  8.6%  14.1%   3.0% D83006Bildeston HC18.9%  11.9%  14.1%   -4.8% D83026Framlingham16.9%  14.7%  13.9%   -3.0% D83058The Norwich Rd12.0%  12.4%  13.1%  1.1% D83044Stow Health14.2%  11.3%  12.8%   -1.4% D83615Gipping Valleyn/a   12.8%   - D83080Martlesham17.5%  10.9%  12.4%   -5.1%

34. 34 Details of practice indicator scores 2/2 Key Below recommended maximum  Above recommended maximum  Increase year on year  No change year on year  Decrease year on year Percentage of Two Week Wait referrals with cancer (conversion rate) 1 Percentage points Recommended maximum: 14% Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83039Chesterfield Dr18.8%  13.9%  12.3%   -6.5% D83082Walton17.1%  23.6%  12.1%   -5.0% D83028Leiston14.5%  10.7%  12.0%   -2.5% D83050Deben Rd23.0%  9.8%  11.7%   -11.3% D83061Wickham Market MC14.8%  16.8%  11.3%   -3.5% D83073Orchard St MP (Blue)10.0%  9.4%  10.8%  0.8% D83020Holbrook10.9%  7.7%  10.6%  -0.3% D83056Hawthorn Dr12.1%  13.7%  10.3%  -1.8% D83059Barrack Lane MC13.8%  13.4%  10.1%  -3.7% D83024Ivry St MP10.7%  12.7%  9.8%  -0.9% D83049Little St John St15.6%  13.5%  9.6%   -6.0% D83037Hadleigh HC15.4%  8.2%  9.5%   -5.9% D83019Mendlesham HC9.4%  13.7%  9.4%  0.0% Y01794Ravenswood MP14.5%  14.2%  9.3%   -5.2% D83079Combs Ford12.9%  11.2%  9.2%  -3.7% D83081Haven Health7.1%  6.7%  9.2%  2.1% D83008Burlington Rd8.2%  7.3%  9.1%  0.9% D83007Ixworth6.6%  7.9%  9.0%  2.4% D83046Woodbridge Rd9.1%  11.2%  7.6%  -1.5% D83017Needham Market Country Pr14.5%  10.7%  7.4%   -7.1%

35. 35 Trend in national and CCG mean average score 20102011201220132014 England mean avg42.9%45.3%46.5%47.7%48.8% CCG/PCT 1 mean avg 43.4%43.9%47.8%46.9%49.8% Key  CCG/PCT 1 mean average CCG range — Recommended minimum = 50% Trend in CCG range 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards. 20102011201220132014 CCG practice min20.0%24.4%29.2%28.6%33.3% CCG practice max68.6%61.3%68.8%64.7%77.1% Recommended minimum: 50% Key — England mean average — CCG/PCT 1 mean average — Recommended minimum = 50% Percentage of new cancer cases treated which are Two Week Wait referrals (detection rates) Aim to be above 50% and have more of your cancer cases diagnosed through the two week wait referral route. Consider doing the RCGP cancer diagnosis audit. Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit Definition: The proportion of new cancer cases treated who were referred through the Two Week Wait route. Indicator source(s): Knowledge and Intelligence Team (East Midlands) based on Cancer Waiting Times data for England, 2012/13, held on the NHS England Cancer Waiting Times Database. For full details see: https://www.cancertoolkit.co.uk/Profiles/ PracticePublic/Documents https://www.cancertoolkit.co.uk/Profiles/ PracticePublic/Documents The Ipswich & East Suffolk CCG mean average for the TWW referral detection rate increased in 2014 and was close to the recommended minimum of 50%. The minimum and maximum TWW referral detection rates for Ipswich & East Suffolk CCG practices increased in 2014. The maximum and minimum TWW referral detection rates were at their highest level in 2014 of the last five years. The Ipswich & East Suffolk CCG average for the TWW referral detection rate increased in 2014 and was close to the recommended minimum of 50%. The maximum and minimum TWW referral detection rates across Ipswich & East Suffolk CCG practices were at their highest level in 2014 of the last five years.

36. 36 Recommended minimum: 50% Distribution of practice TWW referral detection rates within the CCG Percentage of new cancer cases treated which are Two Week Wait referrals (detection rate) Maps contain: Ordnance Survey data © Crown copyright and database right 2012, Royal Mail data © Royal Mail copyright and database right 2012, National Statistics data © Crown copyright and database right 2012 The proportion of practices across Ipswich & East Suffolk CCG achieving above the recommended minimum of 50% for the TWW referral detection rate increased in 2014 as the proportion of practices achieving less than 40% decreased. 5 of the 40 practices (13%) achieved the recommended minimum of 50% for the TWW referral detection rate for each of the last three years. 7 practices (18%) failed to achieve a minimum of 50% for the last three years. The proportion of practices achieving above the recommended minimum 50% for the TWW referral detection rate increased in 2014. 18% of practices failed to achieve the recommended minimum for each of the last three years. 1 Only practices with indicator scores for all three years are included. Targets achieved for last 3 years 1 Key Targets achieved over last 3 years 3 2 1 0 N/A

37. 37 Three year profile (2012 to 2014) Percentage of new cancer cases treated which are Two Week Wait referrals (detection rate) 201220132014 Practices above recommended min.19(40)16(40)20(41) Practices above recommended min. (%) 47.5%40.0%48.8% 58% of practices (23/40) saw an increase in the TWW referral detection rate between 2012 and 2014. The number of practices achieving more than the recommended minimum increased from 16/40 in 2013 (40%) to 20/41 in 2014 (49%). Recommended minimum: 50% Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13 Key 2012 2013 2014 Suffolk Brett Stour Commissioning Ideals Alliance Ipswich Deben Health Group

38. 38 Percentage of new cancer cases treated which are Two Week Wait referrals (detection rate) Recommended minimum: 50% Relationship between screening target and demographics Definition: Correlation coefficient (r) The correlation coefficient measures the strength and direction of a linear relationship between two variables. As a general rule of thumb: 0.7 to 1 or -1 to -0.7 is considered a strong correlation. 0.4 to 0.7 or -0.7 to -0.4: A moderate correlation. 0.1 to 0.4 to -0.4 to -0.1: A weak correlation. -0.1 to 1.0: No correlation There is a weak or no correlation between the TWW referral detection rate and the demographic indicators shown below. No correlation Weak correlation Weak correlation Weak correlation No correlation

39. 39 Details of practice indicator scores 1/2 Key Above recommended minimum  Below recommended minimum  Increase year on year  No change year on year  Decrease year on year Percentage of new cancer cases treated which are Two Week Wait referrals (detection rate) 1 Percentage points Recommended minimum: 50% Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83074Orchard MP35.9%  41.5%  77.1%   41.2% D83019Mendlesham HC54.5%  60.0%  62.1%  7.6% D83041Debenham57.6%  58.5%  60.7%  3.1% D83058The Norwich Rd50.0%  58.5%  59.7%  9.7% D83037Hadleigh HC60.0%  48.0%  59.5%   -0.5% D83015Howard Hs54.5%  43.9%  59.4%   4.9% D83026Framlingham54.9%  64.7%  55.2%  0.3% D83044Stow Health62.6%  52.2%  54.9%  -7.7% D83080Martlesham42.4%  48.1%  54.3%   11.9% D83059Barrack Lane MC47.7%  46.8%  53.3%   5.6% D83052Lattice Barn46.2%  44.1%  52.3%   6.1% D83073Orchard St MP (Blue)63.6%  42.9%  52.0%   -11.6% D83057Framfield Hs43.5%  50.0%  51.5%   8.0% D83054Alderton29.2%  54.2%  51.4%   22.2% D83049Little St John St54.5%  42.9%  51.4%   -3.1% D83028Leiston50.0%  36.6%  51.1%   1.1% D83001Constable Country Rural MP43.9%  52.2%  51.1%   7.2% D83051Derby Rd46.5%  35.5%  51.1%   4.6% D83007Ixworth46.2%  39.2%  51.0%   4.8% D83615Gipping Valleyn/a   50.0%   - D83008Burlington Rd38.0%  34.2%  49.4%   11.4%

40. 40 Details of practice indicator scores 2/2 Key Above recommended minimum  Below recommended minimum  Increase year on year  No change year on year  Decrease year on year Percentage of new cancer cases treated which are Two Week Wait referrals (detection rate) 1 Percentage points Recommended minimum: 50% Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 Y01794Ravenswood MP53.1%  57.9%  48.5%   -4.6% D83046Woodbridge Rd30.2%  57.4%  48.0%   17.8% D83043Eye HC68.8%  60.7%  47.7%   -21.1% D83053Saxmundham HC53.1%  41.2%  47.4%   -5.7% D83039Chesterfield Dr58.7%  38.0%  47.4%   -11.3% D83004Felixstowe Rd MP44.8%  48.3%  46.0%   1.2% D83006Bildeston HC55.1%  57.1%  45.8%   -9.3% D83084The Birches MC48.6%  47.8%  45.8%   -2.8% D83036Church Farm56.3%  42.4%  45.5%   -10.8% D83079Combs Ford52.7%  48.9%  43.8%   -8.9% D83050Deben Rd38.6%  37.9%  43.6%   5.0% D83024Ivry St MP36.4%  52.8%  43.5%   7.1% D83048Central33.1%  35.0%  43.0%   9.9% D83017Needham Market Country Pr62.5%  46.5%  42.9%   -19.6% D83020Holbrook41.7%  50.0%  41.3%   -0.4% D83061Wickham Market MC37.9%  60.4%  40.0%   2.1% D83082Walton41.2%  50.0%  40.0%   -1.2% D83081Haven Health43.5%  36.4%  35.5%   -8.0% D83056Hawthorn Dr29.7%  43.6%  34.3%   4.6% D83069Fressingfield MC60.0%  28.6%  33.3%   -26.7%

41. 41 Trend in national and CCG mean average score 20102011201220132014 England mean avg691583587481522 CCG/PCT 1 mean avg 688656600466431 Key  CCG/PCT 1 mean average CCG range — Recommended maximum = 522 Trend in CCG range 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards 1 Mean average for PCT in 2010 and 2011, CCG for 2012 onwards. 20102011201220132014 CCG practice min351327385211173 CCG practice max103910541132730731 Key — England mean average — CCG/PCT 1 mean average — Recommended maximum = 522 Recommended maximum: 522 Rate of emergency admissions with cancer per 100,000 population Aim to minimize the number of cancer patients requiring emergency admissions. Try to proactively manage cases. Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit Definition: The number of persons admitted to hospital as an inpatient or day-case via an emergency admission multiplied by 100,000 divided by the number of persons in the practice list, expressed as a rate per 100,000 persons. Indicator source(s): Hospital Episode Statistics (HES) data for 1st March 2012 to 28th February 2014 was taken from the UKACR “Cancer HES” offload originally sourced from the NHS Information Centre for Health and Social Care HES dataset. For full details see: https://www.cancertoolkit.co.uk/Profiles/ PracticePublic/Documents https://www.cancertoolkit.co.uk/Profiles/ PracticePublic/Documents The Ipswich & East Suffolk CCG mean average for the rate of emergency admissions with cancer per 100,000 head of population has decreased over the last five years. The minimum emergency admissions rate was at its lowest level in 2014 of the last five years. The mean average rate of emergency admissions with cancer for Ipswich & East Suffolk CCG practices has decreased over the last five years and dropped below the recommended maximum of 522 in 2013. After a notable change in 2013 in the range of emergency admissions with cancer for Ipswich & East Suffolk CCG practices, there was minimal change in the range in 2014. The minimum emergency admissions rate was at its lowest level in 2014 of the last five years.

42. 42 Rate of emergency admissions with cancer per 100,000 population Recommended maximum: 522 Distribution of practice emergency admission rates within the CCG Maps contain: Ordnance Survey data © Crown copyright and database right 2012, Royal Mail data © Royal Mail copyright and database right 2012, National Statistics data © Crown copyright and database right 2012 The proportion of practices remaining below the recommended maximum of 522 for the rate of emergency admissions with cancer per 100,000 population decreased in 2014 as the proportion of practices achieving more than 700 increased. 10% of practices failed to remain below the recommended maximum for the last three years. There has been little change in the distribution of emergency admission rates across Ipswich & East Suffolk practices in 2014 compared with 2013. 9 of the 39 practices (23%) remained below the recommended maximum of 522 for emergency admissions with cancer per 100,000 population for the last three years. 4 practices (10%) failed to remain below the maximum of 522 for the last three years. 1 Only practices with indicator scores for all three years are included. Targets achieved for last 3 years 1 Key Targets achieved over last 3 years 3 2 1 0 N/A

43. 43 Rate of emergency admissions with cancer per 100,000 population Recommended maximum: 522 Three year profile (2012 to 2014) 201220132014 Practices below recommended max.16(40)31(42)28(39) Practices below recommended max. (%) 40.0%73.8%71.8% 74% of practices (29/39) saw a decrease in the rate of emergency admissions between 2012 and 2014. More practices saw an increase between 2012 and 2013 (30/40) than between 2013 and 2014 (18/39). 28/39 practices remained below the recommended maximum of 522 in 2014. Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13 Key 2012 2013 2014 Suffolk Brett Stour Commissioning Ideals Alliance Ipswich Deben Health Group

44. 44 Rate of emergency admissions with cancer per 100,000 population Recommended maximum: 522 Relationship between screening target and demographics Definition: Correlation coefficient (r) The correlation coefficient measures the strength and direction of a linear relationship between two variables. As a general rule of thumb: 0.7 to 1 or -1 to -0.7 is considered a strong correlation. 0.4 to 0.7 or -0.7 to -0.4: A moderate correlation. 0.1 to 0.4 to -0.4 to -0.1: A weak correlation. -0.1 to 1.0: No correlation There is a strong correlation between the rate of emergency admissions with cancer and the proportion of population aged 65+, a moderate correlation with the deprivation indicator and the rate of new cancer cases. The remaining demographic indicators show a weak correlation with the rate of emergency admissions with cancer. Weak correlation Moderate correlation Strong correlation Weak correlation Moderate correlation

45. 45 Rate of emergency admissions with cancer per 100,000 population Recommended maximum: 522 Details of practice indicator scores 1/2 Key Below recommended maximum  Above recommended maximum  Increase year on year  No change year on year  Decrease year on year Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83615Gipping Valleyn/a  358  n/a   - D83073Orchard St MP (Blue)385  355  n/a   - D83074Orchard MP425  462  173  -252 D83028Leiston1006  515  180   -826 D83039Chesterfield Dr473  575  298   -175 D83059Barrack Lane MC466  730  314   -152 D83050Deben Rd1132  561  332   -800 D83046Woodbridge Rd431  456  340  -91 D83008Burlington Rd614  493  343   -271 D83057Framfield Hs833  471  347   -486 D83049Little St John St702  482  376   -326 D83037Hadleigh HC952  382  381   -571 D83051Derby Rd418  326  388  -30 D83024Ivry St MP459  534  390   -69 Y01794Ravenswood MP457  465  390  -67 D83081Haven Health386  211  399  13 D83061Wickham Market MC597  321  403   -194 D83020Holbrook616  471  407   -209 D83052Lattice Barn747  406  411   -336 D83080Martlesham408  403  421  13 D83017Needham Market Country Pr601  535  426   -175

46. 46 Rate of emergency admissions with cancer per 100,000 population Recommended maximum: 522 Details of practice indicator scores 2/2 Key Below recommended maximum  Above recommended maximum  Increase year on year  No change year on year  Decrease year on year Year on year rateAt or above target Difference over 3 years (pp 1 ) 201220132014201220132014 D83079Combs Ford396  395  434  38 D83044Stow Health422  349  447  25 D83082Walton433  455  450  17 D83056Hawthorn Dr886  311  454   -432 D83084The Birches MC618  391  459   -159 D83054Alderton715  630  464   -251 D83053Saxmundham HC778  456  474   -304 D83004Felixstowe Rd MP638  497  476   -162 D83026Framlingham624  359  509   -115 D83019Mendlesham HC664  497  524   -140 D83041Debenham440  458  540   100 D83006Bildeston HC723  440  560   -163 D83048Central796  458  574   -222 D83058The Norwich Rd433  599  622   189 D83043Eye HC473  408  668   195 D83069Fressingfield MC607  438  671   64 D83007Ixworth719  720  679   -40 D83015Howard Hs582  532  683   101 D83001Constable Country Rural MP760  623  719   -41 D83036Church Farm792  527  731   -61