Transcript London Appraiser Training Cancer SEA

London Appraiser Training
Cancer Case Reviews
Dr Pawan Randev
Transforming Cancer Services Team
11th September 2014
Format
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Introduction and context
SEA
Your experiences – Cancer and SEA
The proposed template
Sample SEAs to consider
Resource set
What should our outcomes be?
Introduction
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Pawan
GP Trainer and Appraiser
GP Clinical Lead TCST – Education lead
RCGP Cancer SEA Pilot 2013
“Improving Cancer Awareness” GP Trainers
Developed resources including website
Cancer Lead for 15 years
Significant Event Analysis
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An account of an SEA should not allow patients to be identified and should comprise:
Title of the event
Date of the event
Date the event was discussed and the roles of those present
A description of the event involving the GP
What went well?
What could have been done differently?
reflections on the event in terms of:
o knowledge, skills and performance
o safety and quality
o communication, partnership and teamwork
o maintaining trust
What changes have been agreed:
o for me personally
o for the team
Changes carried out and their effect.
Your experiences of Cancer and SEA
• Have you submitted a cancer SEA?
• Discussed a cancer case with an appraisee?
• Considered a cancer SEA in your practice SEA
meetings?
Sample SEA- 1
Sample SEA - 2
Template for Cancer SEA
• 1. What Happened: Facts of the Case.
• 2. Identification of Key Moments: Issues to Reflect upon
• 3. Learning, Quality improvement and Commisioning
• 4. Implementation of Quality Improvement
• 5. Development of this process
• Some information about the setting for this case
Sample SEAs
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Set of 6 SEAs to practice with in workshops
Small groups 3-5 with activities as below:
What was good/could be developed?
Discuss what feedback you could give to appraisee
How could you challenge/stretch appraisees?
What resources may help deeper thinking?
How to maximise impact of learning –
personal/patient/practice/CCG
• 10 minutes per SEA in small group then large group
discussion/feedback
Resources
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Practice Profiles
Revalidation toolkit
Patient perspectives
Macmillan CDS
RCGP Audit
Educational Modules
Involving the whole team
Practice profiles: what are they?
• General Practice Profiles for Cancer bring
together a range of process and outcomes
information relevant to cancer in primary care.
• Similar principle to PACT data
• They provide readily available and comparative
information for benchmarking and reviewing
variation at a general practice/CCG level.
• They can be used to understand the cancer
burden for a population.
• Not performance measurement as no
established/agreed normal values
Data domains and indicators for your
practice
Demographics
Practice population above 65 years
Socio-economic deprivation
Cancer incidence and prevalence rates
Cancer mortality rates
Cancer Screening
Breast cancer screening rates
Cervical screening rates
Bowel cancer screening rates
Cancer waiting times
2ww referral rates and age standardised ratios
2ww referral conversion rates
Numbers of new cancers treated (% of which are 2ww refs)
Number of 2ww referrals for suspected breast, lower GI,
lung and skin cancer
Presentations and
diagnoses
Number of emergency admissions with cancer
Number of emergency presentations
Number of managed referral presentations (GP involvement)
(Use of investigations: numbers of endoscopic procedures)
Using the Practice Profile
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Giving context to the SEA
Appreciating the larger picture
Understanding what happened over 1 year
Comparing – like PACT data
Not performance management
Seeing a larger setting – practice, CCG and
England levels
Google HEEM ICA
Stepped approach -5 modules
Audit Tool
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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
RCGP Cancer Education Hub
BMJ Learning – free access London
Channel
Doctors.net.uk
Macmillan Cancer Decision Support
Tool
• CDS
Google HEEM ICA