1. Bowel Screening and Call for a Kit Clinic Initiative
Andrea Pugh
BCSP Comm/GP Engagement Worker
Introduction Shahida and Sadiq
Today we are here to talk to you about the Bowel Cancer Screening Programme. We want to tell you all the Who its for?, What is it? Why is it done? So everything About it in a bout 30 mins.? Ok but before we start we would like to ask you a question?????

2. Why is it important? Bowel Cancer Facts
Bowel Screening Facts.
Bowel cancer is the third most common cancer in the UK after lung and breast
Over 8 in 10 bowel cancer cases occur in people aged 60 and over.
In the UK there is a 1 in 20 lifetime risk of getting bowel cancer
Bowel cancer is the 2nd most treatable cancer if diagnosed early
Research suggests over 90% of bowel cancer patients will survive the disease for more than five years if diagnosed at the earliest stage
The screening programme acts as an early warning system for patients who do not have any symptoms.
More than 850 cancers have been detected by the bowel screening programme. Lives have been saved!
Brief facts of Bowel Cancer within the UK

3. What is the Bowel Cancer Screening Programme?
The NHS is trying to screen people all over England to save lives from bowel cancer
A test kit is sent to all people over the age years
The Test kit is completed by people at home and posted to the HUB
The kit finds Faecal Occult Blood (hidden blood in poo which you may not be able to see)
The kit is designed to detect blood in the poo of people without any symptoms of bowel cancer
Other health conditions are unlikely to make you unsuitable for the screening programme

4. Lancashire and South Cumbria
1.7 million population
285,781 - eligible for bowel screening (mid year estimates 2016)
8 CCGs
2 bowel screening programmes (Lancashire and Cumbria- Part) delivered 4 hospital trusts
228 practices
4 Local authorities (Lancashire, South Cumbria Blackburn with Darwen and Blackpool)

5. Indices of Deprivation

7. Local diverse communities….
Some Languages spoken/Read?
English
Urdu
Gujarati
Bengali
Punjabi (Sikh/Pakistani)
Hindi
Chinese (Mandarin/Cantonese)
Arabic
Kurdish
Russian
Czech
Pashto
Farsi
Europeanlanguages
Groups
White English
Indian
Pakistani
Bengali
Chinese
Polish
Black/African
Kurdish
Afghanistan
Arabic
Iran
Iraq
Romanian
Italian
BCSP uptake within some of these communities was around 20%.....

8. The challenge is…… Patient applies sample FOBt testing kit
Positive Spots

9. Core principles for BCSP Health Promotion team in Lancashire…..

10. Connecting with Communities Report - 2011 – CVS led study
16 focus groups held with various multi-ethnic community groups across Lancashire…..
The barriers to uptake, issues and solutions were highlighted by the local communities
Evidence was used as a baseline to plan/deliver health promotion initiatives over the next 7 years ….

11. Community/GP Engagement projects
8 BCSP training packages – various Language's/LD
Multi-lingual resources
Toilet door sticker campaigns
8 CCG Big Inflatable Bowel Road shows
2 week CCG low uptake ward campaigns
Mela/Festival stalls
Barbers/community projects
CCG monthly BCSP project
LD/MH BCSP project
Pharmacy campaigns
TV & Radio campaigns
GP - laminated kits campaign
Flu & Poo campaigns
Bowel Bingo!!
But the persistent challenge was how to show we had made a difference……….and increased BCSP uptake……

13. CFAKC developed due to:
GP practice feedback
Community feedback
5 min GP appts – too many alerts/ clinical time pressures
Lack of primary care staff knowledge re BCSP
Lack of staff capacity for extra BCSP work – when no funding attached
Funding requested for any GP interventions
Many health priorities with no support e.g. dementia, CHD, health checks
Communities lack of knowledge of Bowel cancer, BCSP kits, how to complete and order kit
Cultural, language, fatalistic beliefs
Prevention v medical model/fear of the C word….
Busy life excuses…..
Anecdotal HP team experience of individual face to face contact being positive but…. kit ordering/uptake unmeasurable in the community

14. CFAKC Model/Process Identify low uptake GP Practice
18 month pilot Sept 15-March 17 = 2yr funding from NHS England Oct 17 – Sept 19
Identify low uptake GP Practice
Identify BCSP non responders (NRs) (set search)
Invite NR by phone, Txt, letter or phone
15 min Language/ gender specific CFAKC
HUB ‘called for a kit’
13 weeks outcome
checked
NHS England
GP practice
GP practice/
Rugby HUB
CFAKC team in GP surgery
GP/CFAKC team

16. Gender Percentage %
Male %
Female %

17. Key Languages: English, Urdu, Punjabi, Gujarati & Bengali
Wider equalities data collected within CFAKCs

19. Face to face engagement within GP surgery

20. Telephone consultation within GP surgery

24. Summary ..… CFAKC via Face to Face (Sept 15 – March 18)
No of non responders (NR) invited -3158
Number of NRs seen – 84.76%
Number of kits ordered – 88.27%
No of kits completed from NR seen – 57.76%
Positive results – 26
CFAKC via Telephone Consultations – (6 months data Oct 17 – March 18)
NRs consented for a kit to be ordered – 734
Number of kits completed after a telephone consultation – 36.37%
Positive results – = 33
Total = Bowel Cancers detected <5

25. Outstanding results…April 18 – Sept 18
CFAKC Face to Face
No. of clinics delivered - 73
No. of non-responders invited – 1666
No. of non-responders seen – 1027 (61.64%)
No. of kits ordered – 923 (89.87%)
No of Completed Kits = ?
CFAKC via Telephone Consultation
No. of non-responders consented for a kit to be ordered – 539
No of completed kits = ?
Total patients engaged with
3892 (Sept 15 – Mar 18) +
2205 (Oct 18 - September 18) = 6097 NR engaged
Uptake 58% 33 positives = <5 Bowel Cancers

26. Meet our fantastic CFAKC team 
Thank you

27. Thank you for listening! YOU’VE GOT TO LAUGH…