EOE CA PCG Clinical Huddle July 2021
The July PCG meeting received a presentation from Vardini Vijay , Consultant Surgeon at the Princess Alexandra Hospital in Harlow on the great work done around 'straight to test' in colorectal pathways. This was followed by an update regarding the GRAIL project and primary care communication and referral pathways.
The group had previously considered what data needs to be published about primary care activity in cancer pathways and a possible data pack was discussed. Particular interest was focused on the possibility of obtaining up-to-date routes to diagnosis data, and the potential thus created to improve referrals. The issue of referral quality was linked to a debate about patient access and the implications of differing modes of primary care consultation on cancer pathways, a discussion to be taken forward next month. For the moment a letter will be sent to colleagues via LMCs.
EoE CA PCG Clinical Huddle May 2021
At our May meeting, in addition to our usual agenda, we had two presentations from external speakers.
Firstly, Ben Jackson from EASHN outlined the project to promote the usage of tamoxifen as prophylaxis for those at genetic risk of breast cancer. There is a crucial role for primary care in identification, promotion and eventual drug prescription, and the PCG will support and contribute to this project, though it is important to involve the Breast Network Clinical group and patient representatives. His presentation can be viewed here.
Secondly, Helen Hatcher, Consultant Oncologist at Addenbrooke's, gave an overview of cancer in teenagers and young adults: see presentation. Although an individual primary care clinician may (thankfully) only see a handful of such patients in their professional lifetime, the requirement for increased awareness and communication with primary care was clear, with improvement needed. We hope that Helen's talk will encourage an ongoing dialogue.
The proposed regional development template for the PCN Cancer DES (see here) met with approval and will form a basis for future support for PCNs, enabling identification of areas where the PCG can help most. Continuing the theme of developing a community of practice, the ambition of promoting effective communication between primary and secondary care will be supported by assigning named GPs as representatives to each of the relaunched NCGs.
Finally, the persistent issue of improving the quality of urgent suspected cancer referrals was raised; this will be revisited at future meetings in the context of the PCN DES.
EoE CA PCG Clinical Huddle April 2021
The updated PCN cancer DES and QoF for cancer has just been published and last years' experience across the region was shared. Whilst there was recognition that the pandemic had severely affected both activity and aspirations, it was also accepted the group should provide more support and direction to the diverse spread of PCNs regionally. Last year a webinar was run for each STP, a recording can be viewed here: PCN Cancer Early Diagnosis Specification Webinar (04/08/2020)
These webinars will be updated and repeated , and acknowledging the national resources provided, the PCG undertook to develop an EoE "toolkit" for PCNs to use, particularly agreeing standard audit templates that could be used. This work will be taken forward next month, with a more in-depth review planned for June. The PCG also has a role in developing links between RDCs and PCNs, perhaps using a population health management approach, already piloted successfully in N&W.
Various clinical issues around cancer pathways were discussed: particularly the ongoing varying approaches to FIT in colorectal pathways; and also, the development of "lumps and bumps" diagnostic pathways, for example suspicious lymphadenopathy. The concept of developing Advice and Guidance for cancer pathways was raised and met positively; the perceived need for this to be done at scale might prove problematic, but this idea will be taken forward with the regional A&G team.
Updates were received regarding the GRAIL project, website, the relaunched virtual group CCR project, and Clinical Advisory and Patient Boards. A particular issue was raised about patients accessing information regarding their diagnosis from their online GP record before secondary care appointments and appropriate discussion; an easy solution to this problem was not obvious, but will be continue to be sought.
I hope this update from our Primary Care Group has been of interest,
Yours sincerely, Dr Peter Holloway, Cancer Research UK GP, PCN/CCG/ICS Cancer Lead
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