1. Cancer Palliative list Deaths review Boundary House Medical Centre 16/12/2013 Quarterly review

2. Cancer – National Data Latest data from 2008 – just over 2 million in UK In 2010 - 324,579 patients diagnosed with cancer Breast Cancer is THE most common cancer In women, followed by Lung>Colorectal>Uterus>Ovarian Causes of death – Lung>Breast>Bowel Prostate is the most common cancer in men, followed by Lung>Colorectal>Bladder>NH-Lymphoma Causes of death – Lung>Prostate>Bowel

3. Diagnosis pathways Emergency presentation National average – 23.7% South Manchester CCG – 26.4% North Manchester CCG – 33% HSC205 – Operational standard is 93% to see a specialist within 2 weeks 95.7% national average. 96.2% of Manchester PCT meet this standard

4. Summary Dec 13 Feb 14 Total new cancer diagnosis: Jan-June – 31 July-Nov – 15 Dec – Feb ‘14 – 9 2 prostate 1 breast 1 SCC 1 Colon 1 Bladder 1 Rectal 2 BCC

5. Pick up rates Excluding BCC, 7 new cases 1 referred from Boundary House Rectal Ca via 2ww 3 under relevant specialist 1 prostate 1 Breast – under familial clinic 1 SCC – under derm for actinic keratosis 3 via hospital 1 via A&E – presented with back pain, diagnosed with prostate Ca during admission 2 Admitted on home visits – large PR bleed = colon ca and large haematuria = bladder Ca

6. Two-week referral 102 between Jan-June’13 12/102 = 11.7% positive diagnosis 98 between July – Nov ’13 7/98 = 7.1% positive diagnosis 67 between Dec 13 – Feb 14 1/67 = 1.5% positive diagnosis. However 4 cases still outstanding, if +ve, the rate = 5/67 = 7.5%

7. Doctor variation Total followed by BCC exclusion PG – 1, BCC FMM – 1 BCC YB – 1 2ww – rectal Ca Everyone else – 0.

8. Palliative Care Cancer register – 172 – was 169 Jan-Jul’13 Palliative care list – 12 – was 13 Jan-Jul’13. 3 Dementia 2 Heart Failure 1 SLE 1 CVA 5 Cancer 1 oesaphageal, 1 lung, endometrial, unknown primary, 1 breast 2 < 65yrs of age.

9. Deaths review Total 33 between Jan-June’13 Total 20 between July-Nov ‘13 July – 5 (2 Ca, 1 PE, 1 Pneumonia, 1??) Aug – 3 (1 Pneumonia, 1 Ca, 1??) Sept – 2 ( 1 old age, 1 MI) Oct – 6 (2 LVF, 1 CVA, 1 Ca, 1 Resp. Failure, 1??) Nov – 4 ( 1 Ca, 1 MOF, 1 Suicide, 1??)

10. Deaths review Hospital – 6 Home – 12 Hospice – 2

11. Deaths review – cause Cancer – 5 Unknown –4 MI – 1 Pneumonia – 2 Sepsis – 1 Respiratory failure – 1 (MND) CVA – 1 HF – 2 Multi-organ failure – 1 Old age/Dementia – 1 Suicide - 1

12. Discussion