Welcome to North Central London CCG’s Cancer education page–a resource designed for our GPs, Practice Nurses and primary care teams in NCL in order that you can find educational and learning resources related to cancer all in one section.

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Early Cancer Diagnosis DES/QOF Resources and the Cancer PCN Dashboards

The Covid pandemic has presented specific challenges with regards cancer. Two of the most significant impacts were a sharp reduction in the number of people coming forward to general practice and being referred urgently with suspected cancer and reduced access and referral from cancer screening programmes.

The 2021/22 DES contract specification and the QOF QI module both recognise the pivotal role that GPs play in diagnosing cancer earlier and support the NHS Long Term Plan ambition to diagnose 75% of cancers at stage one or two by 2028.

We wanted to ensure you have the tools, information and support you require to deliver the DES and QOF priorities. Please see list of information and guidance documents and tools below and see the Downloads below for the second iteration of the North Central London Primary Care Network Cancer Dashboards.

The dashboards have been developed primarily to support primary care with delivering the objectives set out in the Network Contract Directed Enhanced Service, Early Cancer Diagnosis Guidance and QOF Quality Improvement domain 2020/21 early diagnosis of cancer guidance.

The dashboard will help practices and wider NCL stakeholders understand the degree of variation across NCL and enable PCN’s to benchmark themselves against the various indicators and prioritise areas for focus.

Information and guidance documents and tools to support GPs to deliver the 21/22 DES/QOF Priorities for Early Cancer Diagnosis are below:

• Macmillan GP resources
• NCL Early Cancer Diagnosis DES/QOF 2021-22 Resource Pack
  Developed with the support of wider stakeholders, this guidance pack ensures a consistent approach to support for primary care across NCL to achieve the DES/QOF “must do’s”. The aim is to simplify the national guidance and outline key deliverables; suggest a number of options and activities that meet the requirements of the early cancer diagnosis and screening priorities; and outline the package of support that the NCL Cancer Team has put in place. 
• Gateway C: A free to use online cancer education platform
• Safety netting toolkits available for EMIS Web eg NCL Cancer Alliance E-Safety Netting Toolkit
• Clinical decision support tools (ie Macmillan)
• CRUK’s Your urgent referral explained leaflet can support conversations with patients
• CRUK resources to support DES/QOF requirements
• The Public Health Commissioning and Operations list of actions that can be taken to improve screening uptake and actions to reduce inequalities
• Cancer Research UK Bowel Screening Hub & Good Practice Guide and Cervical Good Practice Guide
• Easy read leaflets for cervical, bowel and breast screening for people with learning disabilities
• Quality Improvement Tools (QOF):
  • Assessment of practice screening programme uptake rates: PHE Fingertips Data
  • Cancer Research UK: “expected Vs actual” screening uptake tool
  • Macmillan Quality Improvement Toolkit: Early Diagnosis and Screening Modules
  • RCGP Quality Improvement Toolkit for Early Diagnosis of Cancer
  • Undertake a more in-depth learning/significant event analysis
  • Audit and review the current system in place for safety netting around suspected cancer diagnoses as their early diagnosis activity: Macmillan's safety netting and coding module
  • Participation in the National Cancer Diagnosis Audit can help practices and PCNs better understand pathways to cancer diagnosis. The NCDA is now closed, but a word doc proforma which is based on the latest NCDA, is available to download and complete internally. You can find the form in the ‘Get Involved’ box on the National Cancer Diagnosis Audit page.

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Cancer Research UK Facilitators & GP Hub

CRUK Facilitators are working in NCL to support PCNs to improve cancer outcomes for their patients and help fulfil their early diagnosis and DES requirements. CRUK Facilitators can support your network with Quality Improvement activities on prevention, early diagnosis and screening. To invite your CRUK Facilitator along to your PCN meeting to hear more about what we can provide and how we can support you, please email londonfacilitators@cancer.org.uk or Bethany Shaw directly on bethany.shaw@cancer.org.uk

The CRUK GP Contract Hub is also now updated with 2021/22 cancer guidance.

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NCL primary care cancer webinars

A new pathway for managing patients with lower GI suspicious symptoms has been introduced in north central London. It includes the monitoring of patients whose FIT result is less than 10. The New management of patients with suspicious lower abdominal symptoms (FIT < 10 NG12 Safety Netting Pathway) webinar (see right) for primary care professionals, explains when and how to use the different referral routes, as well as other developments in diagnosing patients with lower GI symptoms. The webinar took place on 17 May 2021.

More webinars on other cancer topics such as breast cancer, rapid access diagnostic centres, urological cancers and sarcoma are also available on the NCL Cancer Alliance Youtube Channel

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Toolkits and referral guides

Healthy London Partnership

• Screening Good Practice Guide
• Pan-London Suspected Cancer Referral Support Guide
• Pan-London Suspected Cancer Safety Netting Guide
• GP Top Tips
• Pan-London Suspected Cancer Referral Forms
• Pan-London Guides for Clinicians

North Central & East London Cancer Alliance

• Electronic Safety Netting Toolkit for Cancer – EMIS Web User Guide
• Guide to Quality Coding and Safety Netting in the Context of Cancer

Cancer Research UK

• Early Diagnosis of Cancer

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Learning modules

Watch this video explaining how to use the London Cancer Care Review Template. 

GP practices in North Central and East London can access courses from GatewayC (CPD points available) – register here.

This cancer-screening-awareness session is aimed at reception/admin staff and can be delivered in a lunch period. Find out more and arrange a session.

Other e-learning resources:

• BMJ OnExamination learning – to access please email your name, practice name, CCG and email address to the UCLH team e: uclh.cancer.academy@nhs.net
• Healthy London Partnership resources
• RCGP/UCLH Cancer Collaborative colorectal cancer online course
• Free, BMJ, one-hour module on breast screening in the NHS that's part of CPD. This e-learning explains how to advise women who are concerned about breast cancer and the information to give them.
• Coding and Safety-netting in the context of cancer

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Clinical thinking: Cancer, reflection and appraisal

Cancer survival in the UK is below the European average. No one knows why. Yet frontline doctors can frequently identify factors that could have improved the outcome for individual cases. The appraisal system can be used to collect and coordinate these individual reflections, and by co-ordinating them, create the agenda to improve cancer pathways based on the insights and needs of frontline practitioners. 

You may like to therefore think about including at least one study of a recent cancer case in this year’s appraisal, it is not compulsory. You may well have other cases that are of greater significance, and you are free to choose. But case reflection is important for revalidation, it is one of the best ways to demonstrate that you can detect learning and other quality improvement needs, it is an opportunity for general practice to coordinate quality improvement activity, and with the full support of NHS England, to make the profession’s clinical reasoning the basis for improving cancer pathways. 

Download the cancer SEA appraisal template