improving cancer outcomes in camden
DESCRIPTION
Lucia Grun updates Camden GPs on local strategy to improve cancer outcomesTRANSCRIPT
Improving Cancer Outcomes in Camden
Dr Lucia Grun
19 March 2014
International Cancer Benchmarking Partnership: 5 year relative survival, patients diagnosed 1995-2007: Coleman et al, Lancet 2011
International Cancer Benchmarking Partnership: 5 year relative survival, patients diagnosed 1995-2007: Coleman et al, Lancet 2011
Cancer Late stage five year relative survival
Early stage five year relative survival
Breast 13% (IV) 92% (I)
Lung – Non-small cell 2-13% (4) 58-73% (1A)
Colorectal 6.6% (Dukes D) 93.2% (Dukes A)
Five year survival of common cancers diagnosed Early versus late
Camden-specific statistics…Directly standardised mortality rate aged under 75 for all cancers, Camden, 1993-2011
Source: Health and Social Care Information Centre, 2013, NB data for 2009-11 are provisional at the time of publication.
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Camden-specific statistics…
• The reduction in Camden’s cancer rates has been faster over the past 10 years (27%) than England (22%) or London (25%)
• May relate to greater than average reduction in numbers of smokers in Camden
• In Camden, a higher proportion of people are diagnosed at stage 1 (34%) compared to neighbouring boroughs and the London average.
• Camden also has a significantly higher proportion of cancers diagnosed at stage 4 (late) compared to the London average
Camden Joint Strategic Needs Assessment 2013, Camden Council http://www.camden.gov.uk/ccm/content/social-care-and-health/health-in-camden/joint-strategic-needs-assessment-2012/chapter-16-cancer.en?page=3
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National Patient Experience Survey for all cancers Question 64: Practice staff definitely did everything they could to support patient
Trusts 2012 2013BCFH 60.92% 65.88%BHRUT 60.50% 59.31%HUH 76.67%NMUH 53.80% 57.54%PAH 62.55% 62.84%RFL 60.55% 63.82%RNOH 48.89% 70.21%UCLH 57.10% 55.92%WH 60.00% 61.43%BH 58.53% 62.39%
Data Source:National Cancer Patient Experience survey
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3 year funded project Camden CCG and LondonCancer
Delivered through other workstreams
Improving outcomes for Camden patients
Improve earlier diagnosis of cancer•Developing educational opportunities
o Online learning packageo Integrate results of recent GP questionnaire
•Linking into national awareness campaigns•Reflection on current practice through various methods•Best Commissioning Pathways from NHS England
Improve communication •Interface between primary and secondary care•Facilitate connections between practices and CCG•London Cancer as a way to support this
Improve pathways for patients who present late•Learning from the A&E Audit
• Encourage stronger links into national awareness campaignso Awareness of key messages o Available leaflets and promotion in practices
• Access to appointmentso Patient perceptions
• Uptake in screening programmeso Cervicalo Bowelo Breast
Earlier Diagnosis – Practice based
• Education of reception staff
• Appropriate use of 2ww referral between primary and secondary care
• Creating a low risk but not no risk culture
Earlier Diagnosis - Communication
Earlier Diagnosis - Reflection
• Significant event analysis
• Audit of past cancer diagnoseso Understand patient journey and route to diagnosiso Upcoming audit
• Sharing learning within practices and localitieso Best practice and insights across Camden
• Using practice profileso Available at today’s event
• MacMillan Risk Assessment Tools
Best Practice Pathways for early detection
Numbers of ovarian cancers detected in a theoretical cohort of 100,000 with symptoms consistent with ovarian cancer presenting to primary careAssumed prevalence of undiagnosed ovarian cancer is 0.23% in women with such symptoms- total numbers of ovarian cancer cases is 230
Source: Transforming Cancer Services for London, Best Practice Commissioning Pathway for the early detection of ovarian cancer , NHS England