1. Towards earlier diagnosis of cancer Dr Pawan Randev 6 th October 2014 pawan.randev@nhs.net

2. Overview Introduction The context for Primary Care Why it matters How can you make a difference? Resources

3. About me... GP 3 days a week GP Trainer GP appraiser West Leicestershire CCG Cancer Lead East Midlands SCN Cancer Lead Work with 2 associate GPs and manager

5. The Canadian Medical Association Journal, May 1933

6. Diagnosing Cancer

7. 7 Coleman MP et al, Lancet 2011;377:127-37 Cancer outcomes lag behind similar health economies

8. Why is it so difficult? Patient factors Awareness – mentioning symptoms Patient understanding Symptoms can be vague Co-morbid conditions (lots!) Polypharmacy Patient fear Male/female denial Continuity of care?

9. Why is it so difficult? For Professionals: More than 2/3 problems per consultation More than 6 medications Older patients (range of normal) Fear of cancer – the google patient Cancer is a small numbers game Continuity of care – works both ways! Busy professionals...getting busier!

11. How can you make a difference? NICE Guidance – update in 2015 2 week wait referral forms Clinical Decision support tool SEAs Appraisal Audit Staff Training Understanding Patient Experience Flexi Scope screening All resources here http://tinyurl.com/kl5ctky “HEEM ICA” into Google

15. Decision support

16. Have you ever had a Cancer SEA? Has this been discussed at practice SEA meetings? Have you had a near miss? Have you picked up a cancer that was missed by others? How many patients fear cancer? Do you have a structured approach to recording 2 week wait referrals?

19. New Cancers diagnosis audit Developed by RCGP National audit 2010/11 Excel tool Easy to complete –honest!! Downloadable Tested on over 16,000 cancer journeys Strictly a survey until standards/criteria set and re-audit

20. Primary Care Audit

22. Cancer Awareness Toolkit On Line resource for GP staff Receptionists, attached staff, social care Pharmacists Created by Cumbria Cancer Network Can form part of induction for staff or bring up at appraisal or at practice learning events

23. Resources for staff

24. Cancer Awareness Toolkit

25. Understanding Patient Experience

30. Thank you and questions, please