With funding from NHS England and Macmillan Cancer Support, and developed in partnership with the Clinical Innovation and Research Centre (CIRC), this toolkit combines a body of work to assist general practices.
This report reviews the project and its impact
- Steering committee members
- London Cancer
- Transforming cancer Services Team Healthy London Partnership
- NHS Gloucestershire CCG
- NHS Birmingham Cross City CCG
- NHS Education Scotland
- University of Leeds
- The Hull York Medical School
Information for Commissioners
The Cancer Task Force published Achieving World-Class Cancer Outcomes - A Strategy for England 2015-2020. It contained 96 recommendations across primary, secondary and public sectors. Recommendation 25 stated GPs should be required to undertake a Significant Event Analysis for any patient diagnosed with cancer as a result of an emergency presentation. The SEA template used for this project is the ideal quality improvement tool to implement this recommendation.
A key part of the strategy includes reducing emergency presentations of a new diagnosis and deciphering whether there are specific avoidable contributors; currently just over 20 per cent of all cancers in England present via this route. This Cancer SEA Quality Improvement toolkit for the Early Diagnosis of Cancer can be used to support CCG cancer leads and Macmillan GPs to deliver localised schemes aligned with the cancer strategy and embed their use alongside safety netting and risk assessment tools to improve early diagnosis.
Background on Cancer SEAs
Significant Event Analysis (SEA) is an approach to quality improvement now well-established in general practice. It involves a structured review of all that happened in relation to the event of interest, which may be adverse, exemplary or simply important. The requirements of the Care Quality Commission, annual appraisal and revalidation are increasing emphasis on the quality of continuing professional development and reflective practice.
Between 2009 and 2012, the RCGP in collaboration with NCAT and the Department of Health developed a cancer-specific SEA template as a quality improvement tool with accompanying advice on its use. This proved popular with practices and cancer networks. The template was designed to support GPs to not only complete a quality cancer SEA to a high standard but also as a real vehicle for change with an emphasis on reflection with a non-judgmental approach.
The RCGP has produced a Quality Improvement guide for General Practice to support the whole primary care team on their quality improvement journey.
The RCGP and Macmillan Cancer Support have continued to champion the use of cancer-specific Significant Event Audits with respect to early diagnosis. In 2014 the RCGP partnered with Macmillan Cancer Support to train appraisers to effectively appraise Cancer Significant Event Audits in a way that supports quality improvement in patient care. In this initiative, systematic peer review was incorporated under the imprimatur of the RCGP, in a pilot that was promoted through cancer networks.