inside this issue: · web viewas you will be aware, incomplete or incorrect referral forms can...
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NEW TEST AVAILABLE TO GPS FOR SUSPECTED BOWEL CANCER Since launching the new test (Quantitative Faecal Immunochemical Test or qFIT) for suspected bowel cancer from 1st April 2019, approximately 1,340 tests have been done to end of May. Of which 141 were abnormal (10.5%) requiring a 2ww referral for further investigation.
Overwhelming numbers of patients with normal results, (<10ug HB/ g faeces), have thus avoided the inconvenience of undergoing a colonoscopy procedure and could be assured, with a high degree of confidence, that they do not have colorectal cancer.
In the first two months around 3 in 4 practices have used the test at least once. Whilst this is extremely encouraging practices, particularly those who have not used the test yet, are encouraged to contact Bashir Ramzan, project manager if they are experiencing any issues in using the test.
For further information:
Bashir Ramzan, Project Manager. [email protected] Tel: 07825 276117
A small number of issues have been highlighted since the roll out. Chief amongst these is the use of universal pots rather than the special FIT tubes for sample collection. Practices are reminded that they must use the correct sample collection devices to avoid delays.
Oher issues include no clinical details and/or form with request, use of FIT test for patients who do not meet the NICE DG30 criteria and repeat tests. In the later case, GPs should be aware that there is no evidence that repeat testing is of benefit to patients and if symptoms are persistent or worsening, then suggest 2WW referral.
GPs are reminded to include request forms and avoid repeating tests within 3 months.
Guidance for GPs on FIT for patients with bowel symptoms
https://youtu.be/IUU4kUMJLh8
Contents Page
Quantitative Faecal Immunochemical Test (FIT) 1Faster Diagnostic Standard 2NCL 2WW Completeness Audit 2SUMMIT Lung Study 2Stratified Follow-up Update (Prostate Cancer Pathway) 2Primary HPV screening for Cervical Smears 3Straight to Test (STT) Pathway· Colorectal· Lung
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Do email your GP cancer lead if you have any questions or problems with cancer services.
Barnet CCG [email protected] CCG [email protected] CCG [email protected] CCG [email protected] CCG [email protected]
Faster Diagnostic Standard (FDS) – what does it mean to GPs, primary care and your patients? The Faster Diagnostic Standard known as FDS is a new cancer standard that is being introduced. The standard goes live on 1 April 2020 but Trusts started shadow reporting from 1 April 2019.
The FDS requires that the patient is informed of a cancer diagnosis, or that cancer has been ruled out, within 28 days of receipt of the referral.
This includes the following referrals: Two week wait GP (GMP, GDP or
Optometrist) referral for suspected cancer, Urgent referral from a cancer screening
programme (breast, bowel, cervical),
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NCL GP and Primary Care Cancer Newsletter June 2019
Two week wait referral of any patient with breast symptoms (where cancer not suspected),
What do the patients need to know? Patients are increasingly being seen within 7 days of referral but should also make themselves available for 28 days following a 2WW referral so that they can attend appointments and any diagnostic tests.
For queries relating to NCL STP: Lucy McLaughlin,
Head of Cancer [email protected] Tel: 07976632999
The Pan London Patient Information Leaflet has been updated and is available now. The changes include information regarding diagnostic tests, e-RS as well as links to Cancer Research UK and Macmillan Cancer Support Websites. They are available in 12 of the most commonly spoken languages in London via the pan London HLP website: https://www.healthylondon.org/suspected-cancer-referrals/patient-information-leaflets/
Pathway specific leaflets, outlining the expected step, appointments and potential tests for these pathways, are also in development and will be circulated in due course.
See version 10 of the National Guidance: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/cancerwaitingtimescwt
NCL 2WW Completeness Audit due to take place Last year NCL STP undertook an audit of 2WW referrals. There was some learning that was fed back to individual practices.
Trusts continue to highlight issues with quality of referrals, but without specific detail it’s difficult to take positive action.
As you will be aware, incomplete or incorrect referral forms can cause pathway delays and additional administrative burden for primary and secondary care colleagues. Poor quality referrals, or incomplete forms could mean that patients may not be directed to the most appropriate pathway, leading to unnecessary steps and/or delays.
Proposal Prospective audit to include all 2WW referrals received into NCL trusts during August 2019To include B&CNS, Gynae, Haem, H&N, LGI, Lung, Sarcoma and UGI referralsNext Steps Following the audit it is expected that next steps may include feeding back to individual practices as required; consideration of speciality specific training sessions if necessary; to include any learning for proposed DoS updates.
The SUMMIT Study was launched in April 2019 at UCLH, Finchley Memorial, King George (BHRUT) and Mile End (Bart’s Health) Hospitals.
The study aims to detect lung cancer early using the proven method of low-dose CT (LDCT) screening of at-risk individuals and support the development of a new blood test for the early detection of multiple cancers.
There has been a positive response from invited patients and so far, over 1,000 people aged 55-77 have had a lung health check and a low-dose CT scan. Across north London, 107 GP practices have registered to take part in the study. All practices are encouraged to take part in order for their patients to get invited. The SUMMIT Study has gained approval from the Confidentiality Advisory Group (part of the Health Research Authority) to collect personal identifiable information of potentially eligible participants from participating GP practices. All IT for the study has been developed to NHS Information Governance and IT standards, and all data will be handled according to the General Data Protection Regulation (GDPR) and Data Protection Act. The study processes and documentation have been reviewed by the Information Governance and FOI Manager/Data Protection Office for North Central London CCGs and is satisfied with they are in line with regulations.
Register your practice to join the study at the following link: http://bit.ly/SUMMITStudy. The study has been designed to minimise additional work to practices and your practice will get paid £250 for supporting the study.
For further information contact the study team on [email protected]
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Stratified Follow up for Prostate Cancer As you will all be aware we have been working to get the prostate cancer follow-up service off the ground and we would like to take this opportunity to thank you first, for your continued patience while we work with our providers to identify and release patients, and secondly to thank you for following up the patients that have already been discharged.
We have now employed a dedicated resource to help unblock some of the bottlenecks at the hospitals and wanted to reassure you that we are making progress. Should you need any assistance on suitable call and recall systems, please contact Sarita Yaganti, Macmillan Stratified Pathways Lead.
For further information:
Sarita Yaganiti, Macmillan Stratified Pathways Lead. [email protected] Tel: 07791574106
In the meantime, please watch this space for further updates and opportunities to attend some workshops.
For further information: Margaret Morgan
at Health Services Laboratories. [email protected] Tel: 020 7307 387
Primary HPV screening for Cervical SmearsFrom 15th April 2019 Primary HPV Screening has been implemented in the lab for all smear samples, as part of changes to the National Cervical Screening Programme. All sample takers need to undertake the e-learning course, which is accessible on the e-learning for healthcare website, to equip them with the High Risk HPV primary screening knowledge they need.
You just need to login to the website https://www.e-lfh.org.uk/ or if not already registered, then need to register on the site to gain access. When you are logged in if you go into the NHS Cervical Screening Programme you will find Primary HPV screening e-learning for sample takers there and this is what you need to complete.
Should you want to arrange some face to face training, or to visit the lab this can be arranged. There will be further training sessions in the Autumn, as part of go live across London.
Colorectal Straight to Test (STT) Pathway In order to align with the National Guidance for Implementing a Timed Colorectal Cancer Diagnostics Pathway, Royal Free London (RFH) NHS Foundation Trust – Hampstead site (RFH) switched off ERS direct bookings for 2WW face to face appointments on the 2nd May. GP’s are no longer able to book into face to face clinics. RFH continue to offer ERS booking into the STT service and capacity has been increased to accommodate these changes. Face to face clinic appointments will remain available following triage by the STT service, but not for direct booking by GP’s. This service change will bring RFH in line with other providers in London, and will lead to more rapid diagnosis of colorectal cancer for patients.
For further information about the Timed Colorectal Cancer Diagnostic Pathway, https://www.england.nhs.uk/wp-content/uploads/2018/04/implementing-timed-colorectal-cancer-diagnostic-pathway.pdf
Lung Straight to Test (STT) PathwayIn order to align with the national optimal lung cancer pathway, Royal Free London (RFH) offers e-Referrals bookings into a lung cancer straight to test (STT) service.
Instead of booking a face to face appointment in e-Referrals, you now select and then book a virtual appointment in our Assessment Clinic. The referral will be triaged and the patient contacted within two workings days to arrange an appointment. The vast majority of patients will have a CT chest scan. Capacity has been increased in the face to face clinic to accommodate changes.
This service change will lead to more rapid diagnosis or ruling out of lung cancer for patients and brings RFH in line with other providers in London.
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More information about the national optimal lung cancer pathway and its implementation is available online .
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