1. PSA Shared Care Jim Wood

2. Background A significant number of men with prostate cancer (CaP) are receiving regular hospital follow up (out- patient visits), who might be more efficiently managed in primary care. A significant number of men with prostate cancer (CaP) are receiving regular hospital follow up (out- patient visits), who might be more efficiently managed in primary care. The shared care (SC) scheme is currently being piloted in Mid-Devon. The shared care (SC) scheme is currently being piloted in Mid-Devon.

3. Aims of the project To improve quality of care for men with prostate cancer and/or raised PSA To improve quality of care for men with prostate cancer and/or raised PSA To reduce the frequency of hospital follow up visits for men with prostate cancer/raised PSA. To reduce the frequency of hospital follow up visits for men with prostate cancer/raised PSA. To provide an agreed framework for the management of these men between primary and secondary care. To provide an agreed framework for the management of these men between primary and secondary care.

4. Eligibility Men with stable disease on hormone therapy or no active treatment (watchful waiting). Men with stable disease on hormone therapy or no active treatment (watchful waiting). Men who have previously received radical treatment i.e. with curative intent (usually radical prostatectomy or radiotherapy), who are now on routine monitoring with stable PSA. Men who have previously received radical treatment i.e. with curative intent (usually radical prostatectomy or radiotherapy), who are now on routine monitoring with stable PSA. Men with a raised serum PSA who have not been diagnosed with prostate cancer, but require regular PSA monitoring. Men with a raised serum PSA who have not been diagnosed with prostate cancer, but require regular PSA monitoring.

5. Aims of the pilot Assess the impact of introducing the SC scheme in Mid-Devon prior to more widespread use Assess the impact of introducing the SC scheme in Mid-Devon prior to more widespread use Identify: Identify: 1. total number of CaP patients in Mid-Devon 1. total number of CaP patients in Mid-Devon 2. number receiving shared care 2. number receiving shared care 3. number receiving hospital follow up alone 3. number receiving hospital follow up alone 4. number receiving GP care alone 4. number receiving GP care alone 5. number receiving no prostate cancer follow up 5. number receiving no prostate cancer follow up For all these pre and post the project. For all these pre and post the project. Establish how many men can be managed by SC; if this is a significant number this will allow us to roll out the initiative across the region. Establish how many men can be managed by SC; if this is a significant number this will allow us to roll out the initiative across the region. The aim is to complete the project in Mid-Devon by end March 2011 The aim is to complete the project in Mid-Devon by end March 2011

6. Figures so far From data we have had back so far 401 patients identified. From data we have had back so far 401 patients identified. The urology team have analysed 95 of these so far and of those 55 (58%) would be appropriate for shared care. The urology team have analysed 95 of these so far and of those 55 (58%) would be appropriate for shared care. Mr Crundwell estimates these average 3 follow up appointments per patient per year. Mr Crundwell estimates these average 3 follow up appointments per patient per year. Extrapolating this for patients identified so far (assuming 58% will be eligible for shared care) – would save 696 outpatient appointments per year. Extrapolating this for patients identified so far (assuming 58% will be eligible for shared care) – would save 696 outpatient appointments per year.

7. Next steps Contact practices directly that we do not yet appear to have had results from. Contact practices directly that we do not yet appear to have had results from. Acting as liaison between Urologists and practices. Acting as liaison between Urologists and practices. Report back on the outcome of the Project via the MDCF. Report back on the outcome of the Project via the MDCF.

8. Any questions?