Primary care improvement 

GPs and those working in primary care have an important role to play in diagnosing people with cancer early, supporting them to access appropriate services in a timely manner and following up their care proactively post treatment. We are working with primary care colleagues in a number of ways to help them support the communities they serve. 

Some of our projects are detailed below. Click here for more information on other cancer education and awareness projects.

  • Coding and safety netting

    Safety netting ensures patients undergoing investigations for cancer, or presenting with symptoms which could indicate serious disease, are followed up in a timely and appropriate manner.

    The term safety netting includes a wide range of actions and procedures. These may involve actions at an individual GP-patient consultation level and procedures implemented at a practice level. Safety netting is particularly important for suspected cancer, where symptoms are common and often non-specific.

    A common example is when GPs refer patients to hospitals for further tests or specialist consultation. Once a referral is made the GP can make a note on their electronic system to remind them through an alert (safety net) to check whether the patient has been offered an appointment at the hospital, has attended, the results of investigations have been shared and the patient has been informed of the findings.

    We are working to support GPs by providing practical solutions that address the need for rigorous safety netting in primary care.

    Electronic safety netting toolkit for cancer for GPs

    We have created an electronic safety netting toolkit for cancer that can be used by GPs faced with various ‘cancer related’ clinical situations. The toolkit gives GP practices a template/form that schedules diary reminders in their system and reminds and alerts practice staff to follow up at a later date. EMIS Web have made our solution nationally available on their system, meaning that all GP practices using EMIS can now access this toolkit.

    The toolkit concept was conceived in collaboration with the Transforming cancer services team for London (TCST) and has undergone a feasibility trial and several QI PDSA cycles conducted by UCLH Cancer Collaborative to reach its final comprehensive version with feedback from our pilot GP sites.

    To support GP practices implement the toolkit we have produced a video user guide.

     

     

    As well as a PDF user guide.

     

     

     

     

     

     

     



    To locate the toolkit files on your EMIS Web system please find further instructions here.

    We are visiting CCGs in our region to ensure GP's are aware of this toolkit and we are undertaking research methods to study the impact of our toolkit. 

    Coding and safety netting e-learning for GPs

    We have developed an e-learning module with Macmillan Cancer Support - Coding and safety netting in the context of cancer. The module has been accredited by the Royal College of General Practitioners (RCGP).

    The course is suitable for GPs, GP trainees and other primary care clincial staff. The aims of the course are:

    • To be aware of the clinical and non-clinical implications of coding
    • To raise awareness of the benefits of coding and safety netting in improving clinical care, diagnosis and community management of individuals with cancer and other long term conditions
    • To gain skills in high quality coding and electronic methods of safety netting within everyday clinical practice.

    We have also developed a guide to help GPs improve the quality of their coding and safety netting.

    For more information please contact

    Dr Afsana Bhuiya - afsana.bhuiya1@nhs.net

    Vanessa Ponussamy - vanessaponnusamy@nhs.net

  • Cancer Care Review (CCR) quality improvement pilot project

    The Cancer Care Review (CCR) is a holistic conversation that assists a person affected by cancer to raise any issues about their cancer or treatment that are impacting on their quality of life or well-being. The CCR is carried out by the GP or practice nurse within six months of them being notified that the person has a cancer diagnosis. It provides an opportunity for the person living with and beyond cancer to think through their needs and, together with their GP/practice nurse make a plan about how to best address these needs.

    The CCR is part of the Recovery Package. This package is a set of key interventions which can greatly improve outcomes for people living with and beyond cancer. The Recovery Package was developed by the National Cancer Survivorship Initiative (NCSI) in partnership with Macmillan Cancer Support.

    We are carrying out a quality improvement pilot across the UCLH Cancer Collaborative region. This pilot involves GP practices who are using a new electronic template installed within their IT system to support their Cancer Care Reviews.

    As part of the pilot we are delivering training to practice staff to support them to use the tool effectively, project management support, a user guide and regular practice visits to help troubleshoot. We are also capturing feedback from both primary care clinicians and patients to help us make improvements to the tool and the way it’s used. 

    If you are a CCR pilot practice and you are capturing patient feedback using the template, you can download a pdf copy of the patient evaluation questionnaire here

    To find out more about Cancer Care Review quality improvement pilot project please contact Sharon Cavanagh, sharon.cavanagh@nhs.net.

    If you are a person affected by cancer and want to know more about CCRs then please contact your GP Practice.

  • Supporting GPs in their referrals for urgent suspected cancer

    We are committed to supporting GPs in their referrals for urgent suspected cancer.

    Pan- London two week wait referral forms and information about referrals can be accessed at www.myhealth.london.nhs.uk

    The My Health London website provides access to:

    • New Pan-London Suspected Cancer Referral Forms (2016) – available for EmisWeb, SystmOne (Integrated, Non-integrated), Vision and DXS
    • Educational Support
    • Patient Information Leaflet