Cancer practice profiles Just another set of league tables or something useful to help us understand and address differences in results? Phil Bennett-Richards GP Aberfeldy Practice

Objectives Introduce the topic of practice profiles for cancer Share some learning resources Open discussion on how we might reflect on current performance at a practice level Stimulate consideration of changes to practice

Public Health England report finds Tower Hamlets with ‘lowest life expectancy in London’

Dr Tania Anastasiadis, a local GP and the clinical lead for cancer at NHS Tower Hamlets Clinical Commissioning Group (CCG) explained that Tower Hamlets has the highest death rates in London because of heart disease, stroke, cancer and chronic lung disease.

Press release from NHS London Lowering the age of referrals, speedier access to tests, and more community programmes to help people spot the early signs of cancer are among a raft of new measures to tackle the capital’s biggest cause of premature death. The plans for the first year will mainly focus on early detection, in a bid to cut the substantial number of Londoners who are diagnosed late. Currently, more than a quarter of cancers are diagnosed in A&E or as an emergency referral.

Increasing Cancer Awareness Train the Trainer series of seminars in March 2014 NHS England project Training GP trainers across London in signs and symptoms of cancer and how to use simple tools to improve referral rates for suspected cancer.

Many interesting pieces of learning of which practice profiles was but one. Use of risk assessment tools RCGP New Cancer audit tool Cancer significant event analysis Cascading of training to practices and future GP trainees Communications skills in cancer diagnosis - DVD resource Patient experience films

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The position of the practice with respect to the range of other practices within the CCG should be taken as possibly indicative of an effect of interest, but not conclusive. These statistical significance calculations take into account the small numbers present for some of the indicators. However indications of statistical significance are again not conclusive – in some cases they are caused by chance fluctuations.

Many practices will be significantly different to the mean on one or two indicators – don’t panic! In general, for any practice, the more indicators that are significantly different, the stronger the argument for understanding why this should be the case. This explanation may often be grounded in the practice population, age, socio-economic status or the ability of the practice to influence change.

Particularly consider the indicators for which your practice is significantly different from the CCG mean and discuss amongst yourselves and with colleagues Think about the reasons and if any actions need to be taken in the practice or by others providing services or interventions on any part of the patient pathway.