CRUK PRIMARY CARE ENGAGEMENT PROGRAMME

EARLY DIAGNOSIS AND GOOD PATIENT CARE: THE EVIDENCE 15 TH NOVEMBER 2014 TOMAS EDGE

The Good News

— Cancer survival rates are improving — Screening programmes help prevention and early detection — You DO a great deal and CAN improve survival and health — Teamwork key to coordination of care — We are here to help!

Overview of cancer in Liverpool

• Incidence significantly higher than England. • 3 top cancers for men: lung (20.3%), prostate (18.7%), bowel(13.3%).

• 3 top for women: breast (25.8%) lung (19%), bowel (9.2%). • Liverpool has 200 more deaths per 100,000 than England.

The Gap– e.g. Lung cancer

Liverpool PCT - Mortality from Lung Cancer / Annual Trend per 100,000 population (Directly Standardised Rate – under 75) 60 30 20 50 40 80 70 Liverpool PCT Rate Sum of England Average 10 0 5NL 1993 5NL 1994 5NL 1995 5NL 1996 5NL 1997 5NL 1998 5NL 1999 5NL 2000 5NL 2001 5NL 2002 5NL 2003 5NL 2004 5NL 2005 5NL 2006 5NL 2007 5NL 2008 5NL 2009 5NL 2010

Mortality Forecast (Liverpool)

Routes to Diagnosis: NB emergency have worse prognosis

Routes to Diagnosis- lung cancer

2WW Referrals

• • High conversion rate implies an efficient use of 2ww pathway High detection rate implies fewer patients being diagnosed by slower routes, i.e routine referrals and emergencies •

High conversion rate coupled with high detection rate demonstrates good clinical practice

• • • Low conversion and high detection might mean overuse of 2ww pathway High conversion but low detection might mean underuse of the 2ww pathway Low conversion and low detection, poor at case selection? (Implies poor clinical practice)  Detection Rate Conversion Rate

What can you do?

• • • •

Share insight – then they will see.....

Share knowledge – then they will know.....

Share skills – then they will act....

Scare then – then they will change......

• • • • • • • Promote healthy lifestyles Encourage Screening: Encourage people to present earlier Recognise symptoms/ signs/risks + (RATs) Investigations and Referrals Robust systems- no gaps!

Reflect and review

After Miller WR (2004)

Prevention

“in the last 5 years, more than 750,000 cancers in the UK could have been prevented”

Encourage Screening

If Liverpool reached national 60% target (i.e.11.4% Increase): ― 54.4 more FOB Positives ― 21.76 more pre cancerous polyps ― 5.44 more cancers detected early ― Big opportunity to address health inequalities

Early detection: 2 great tools: RCGP Audit Tool and Practice Profiles

• RCGP: Dozens of mini significant event analyses • Allowed GP practices to benchmark referral rates against others • • Allowed clearer picture of referral patterns Helped with service redesign • • Helped lead GPs to focus on areas of greatest need with evidence to back this up Profiles: Allowed comparison with previous years

14 Wednesday, April 29, 2020 View to alter this text

CRUK Primary Care Programme

Supporting clinicians, CCGs, commissioners, public health to prevent & detect cancer earlier in your community

Together we can make a difference

THANK YOU

Tomas Edge – Senior Primary Care Engagement Facilitator [email protected]

Tel: 07733 451031

cruk.org