Cancer app developed by GPs being trialled by CCGs

A GP-developed app aiming to help GPs navigate the tests and urgent referrals necessary for patients presenting with cancer symptoms is being trialled by two CCGs | Pulse

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C the Signs was co-founded by newly qualified GP Dr Bhavagaya Bakshi and fellow doctor Miles Payling and quickly checks symptoms of more than 200 cancers against multiple diagnostic referral pathways.

Last week the app won the People’s award at the Tech4Good awards and is now set to be trialled with GPs in the East of England to test its real world cost and clinical effectiveness.

Read the full news story here

Immediate chest X-ray for patients at risk of lung cancer presenting in primary care

Neal, R.D. et al. (2017) British Journal of Cancer. 116, pp. 293-302

AS0000184F07 Hospital doctors looking at X-ray of lungs

Image source: Anthea Sieveking – Wellcome Images // CC BY-NC-ND 4.0

Background: Achieving earlier stage diagnosis is one option for improving lung cancer outcomes in the United Kingdom. Patients with lung cancer typically present with symptoms to general practitioners several times before referral or investigation.

Conclusions: We have demonstrated the feasibility of individually randomising patients at higher risk of lung cancer, to a trial offering urgent investigation or usual care.

Read the full abstract here

Commissioning groups’ performance on cancer care in England

Edwards, N. (2016) BMJ355:i5554

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It doesn’t look good, but CCGs are only one part of the pathway

NHS England, the body responsible for overseeing local clinical commissioning groups (CCGs), recently published information on how these groups are performing on cancer care. The results were not good. Almost nine out of 10 CCGs were failing (180/209) with only 14% (29) doing well or better.

But beyond the headline figures, these results tell us more about the mess that remains following the 2012 Health and Social Care Act and about how policy makers are running out of ideas on how to make change happen.

The measures cover four indicators. On average CCGs had 50% of cancers diagnosed at stage 1 or 2—showing improvement, but some way from the 2020 target of 62% specified by the independent cancer task force that informed NHS England’s strategy. Only three CCGs came close, with the worst performing CCGs managing just over 30%.

Average one year survival for all cancers is just under 70%, but with a spread of 10 percentage points between the best and worst performing CCGs (64% to 74%). The survival target for 2020 is 75%. Patient experience was high compared with hospital services more generally, at 88%, but varies widely (67% to 96%).

Read the full editorial here

HPV cervical cancer test introduced in England

BBC Health News. Published online: 4 July 2016

Illustration showing an artists interpretation of a Cervical cancer cell

The NHS in England is introducing a “superior” test for cervical cancer, following a successful pilot programme. Experts say it is a switch that could pick up an extra 600 cancers a year.

Women invited for a routine smear test will now automatically be checked for an infection called HPV (Human Papilloma Virus), which has been strongly linked to cervical cancer. Until now, an HPV test has only been done if doctors noticed abnormal cells in the smear sample.

Public Health Minister for England Jane Ellison said: “These changes are a breakthrough in the way we test women for cervical disease. The new test is more accurate, more personal and will reduce anxiety among women.

Read the full news story here

GPs should have direct access to wider range of tests for suspected cancer, says NICE

Mayor, S. BMJ. 2016. 354:i3686

Image shows colour lithograph of endoscopy operations.

GPs should have direct access to a wider range of tests for people with suspected cancer including diagnostic endoscopy, ultrasound, x ray, and scans, the National Institute for Health and Care Excellence (NICE) has recommended in a new quality standard aiming to speed up cancer diagnosis.

The quality standard sets out measures the NHS should include in planning and delivering services. In addition to recommending that GPs have direct access to ultrasound, x ray, magnetic resonance imaging (MRI), and computed tomography (CT) scans, it says that they should be able to directly refer people with symptoms suggestive of oesophageal or stomach cancer for urgent upper gastrointestinal endoscopy.

After reviewing relevant research evidence NICE says that GPs should be able to refer patients of any age with dysphagia and those aged over 55 with weight loss and upper abdominal pain, reflux, or dyspepsia for upper gastrointestinal endoscopy. This test should be performed and results sent back to the GP within two weeks of the request.

Read the full article here

Commissioning better cancer services

NHS England has published guidance to support commissioners and strategic clinical networks to ensure every person affected by cancer will have access to a recovery package and follow-up pathways by 2020, as set out in the cancer strategy.

The guidance includes checklists for developing service specifications, practical examples and templates to use and adapt locally.

Full reference: Implementing the Cancer Taskforce Recommendations: Commissioning person centred care for people affected by cancer