Important Updates for GPs on Suspected Cancer Referrals, Rapid Diagnostic Clinic and More
- SE London Cancer Alliance (SELCA) Important Updates for GPs (22nd March 2021). New updates in this edition: National Cancer Diagnosis Audit results available for download and Primary Care Webinar series (updated list of content)
Patient information
- Patient information on 2ww referral during COVID-19 (Transforming Cancer Team) (Translations: Chinese, Hindi, Urdu, Polish, Turkish, Bengali, Gujarati, Arabic, Punjabi, Somali)
Cancer referrals and safety netting
- SEL Cancer Alliance: Advice for GPs on changes to cancer pathways and safety-netting
- Changes in Cancer Pathways and Safety-Netting webinars: Lewisham, Greenwich & Bexley ; Lambeth, Southwark & Bromley
- Updated Pan-London Urgent Suspected Cancer (2WW) Referral Forms for Lung, Breast and Lower GI
- Algorithm for primary care covering cancer pathway changes and safety netting for lower GI, Lung and Prostate Cancers, and symptoms not meeting updated two week wait criteria
Colorectal cancer
- Endoscopy ‘Please do, Please Don’t Guidance’ Please check this guide before making a referral. This guidance has been issued in order to provide an update to primary care on the recovery of endoscopy services in SE London as well as how primary care colleagues can support patients and staff in conducting a timely investigation.
- FIT results: Across SE London we’ve noticed a worsening in the proportion of suspected LGI cancer referrals coming through with a FIT result, which is a critical part of the referral for the triage processes in place. All patient must have FIT done before referral, except if anal/ rectal mass or anal ulceration Having the FIT is extremely important to help ensure patients are referred to the most appropriate test as quickly as possible, as well as helping prioritise by clinical urgency. In light of this, the SE London Cancer Alliance and borough cancer leads have developed a one-page PDF covering this for GPs and primary care colleagues. Information for GPs on use of FIT in Colorectal 2WW pathway
Haem-Onc cancer
Lung Cancer & COVID-19
It is important to be alert to overlapping symptoms between lung cancer and COVID-19. Urgent referrals for suspected lung cancer are much reduced.
Prostate cancer
- Management of patients with suspected prostate cancer. Patients should continue to be referred onto the 2WW pathway for suspected prostate cancer using the pre-COVID referral criteria. These standards have not changed. Within secondary care, Diagnostic clinics and MRI services have been restored and able to manage patients referred with an elevated age-specific PSA.
Early Diagnosis PCN DES Specification: SE London Cancer Alliance, in collaboration with Borough GP Cancer Leads have developed a primary care educational work programme to support PCNs to deliver the Early Cancer Diagnosis PCN DES Specification. This section will be updated regularly with resources to support PCNs in delivering the DES.
- PCN DES Support Guide (Feb-21 update). A practical guide for PCNs to achieve delivery of the service requirements in 2020/21 for Early Cancer Diagnosis of the Network Contract Directed Enhanced Service
Webinars
- Primary Care Cancer (Youtube) Webinar Recordings
- Changes in Cancer Pathways and Safety-Netting webinars: Lewisham, Greenwich & Bexley ; Lambeth, Southwark & Bromley
Education for Primary Care
Personalised care, health and well-being
- Cancer Wellbeing London website to help support self-management and healthy living for those affected by cancer.
The website includes a series of patient information videos which cover a range of topics, including emotional wellbeing, managing fatigue, diet and exercise. Also provides signposting to some of the COVID-19 specific resources and support services, currently available. These cover psychosocial information and support services, physical activity and bereavement information and support.
- Macmillan has also developed a patient hub for patients with cancer who are worried about COVID-19
Screening
- SEL Cancer Alliance update: Restarting breast screening in SE London. Please note that breast screening is deemed essential and so continues under Tier 4 restrictions.
- NHSE/I update designed to help practices explain how breast screening is working during the pandemic
- Cancer Research UK has produced a handy one-page PDF to help practices support people accessing general cancer screening services during recovery from the Covid-19 pandemic.
- FAQs for GPs on cervical screening relating to the restarting of the Cervical Cancer Screening Programme in SE London
NHS England and Improvement have asked CCGs to distribute their letter of 16 November to primary care providers about the restoration of screening services following the first peak of Covid-19. It will take some months for all screening programmes to be fully restored, but we are now seeing the screening rates increasing. NHS England would like to thank you for the efforts you and your staff are taking which has achieved a rate of cervical sample taking in London that exceeds pre-Covid levels.
Last week we mentioned that NHS Improvement and England had produced a PDF
to help GP practice managers and nurses explain to patients how breast screening is
working in response to Covid-19. We’ve been asked to point out that there have been
problems with the helpline telephone number provided, and so people should call 0203
758 2024. NB: The new number is on the above PDF too.
Cervical Cancer Screening Video
A blog and short film has been developed by Jo’s Trust in collaboration with NHS England and NHS Improvement and Public Health England colleagues.
Cervical screening in primary care should continue and people on the Shielded Patient List should be invited to attend screening appointments as normal (National Primary Care Bulletin 19th January 2020).
Cancer referrals and safety netting
- Endoscopy ‘Please do, Please Don’t Guidance’ This guidance has been issued in order to provide an update to primary care on the recovery of endoscopy services in SE London as well as how primary care colleagues can support patients and staff in conducting a timely investigation.
- SEL Cancer Alliance: Advice for GPs on changes to cancer pathways and safety-netting
- Updated Pan-London Urgent Suspected Cancer (2WW) Referral Forms for Lung, Breast and Lower GI
- Algorithm for primary care covering cancer pathway changes and safety netting
- Patient information on 2ww referral during COVID-19 (Transforming Cancer Team)
Breast Cancer Risk Assessment at GSTT
The risk assessment service is based at the Clinical Genetics Department at Guy’s Hospital and it is run by skilled breast cancer family history nurses. The service covers the London boroughs of Bromley, Lambeth, Lewisham and Southwark and we see over 700 patients a year. Approximately 75% of the patients seen there are at higher than population risk of developing breast cancer and require enhanced breast screening from the age of 40. Risk, chemoprevention and screening advice given to patients is based on national guidance (NICE CG164). All patients receive health advice, breast awareness information and referrals to genetic services and breast screening when appropriate. The team are also able to refer patients to a clinical psychologist within the Genetics Clinic if necessary.