1. 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

2. 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!

3. 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.

4. The Gap– e.g. Lung cancer

5. Mortality Forecast (Liverpool)
Still need to do more

6. Routes to Diagnosis: NB emergency have worse prognosis

7. Routes to Diagnosis- lung cancer

9. 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

10. 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

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

12. 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

13. 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

14. Wednesday, November 14, 2018
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15. CRUK Primary Care Programme
Supporting clinicians, CCGs, commissioners, public health to prevent & detect cancer earlier in your community

16. Together we can make a difference

17. Thank You
cruk.org
Tomas Edge – Senior Primary Care Engagement Facilitator
Tel: