RCGP Bright Ideas: The Cancer Maps

13 December 2019

Primary care professionals delivering care on the frontline are busy ensuring people have the best care and health outcomes. Often, they discover better ways of doing things: better because they improve patient outcomes, save time or reduce costs.

This year the College recognised GPs and practices with Bright Ideas Awards for innovative approaches which have improved efficiency and reduced workload in primary care. The award winners included Dr Ben Noble, Associate Clinical Cancer Lead at East Midlands Strategic Clinical Network, awarded for Cancer Maps, a referral algorithm that supports the recommendations in the NICE guideline on recognition and referral for suspected cancer.

The RCGP will host a on the Cancer Maps to enable primary care teams to learn how to use them and adapt the system to other clinical contexts.

Dr Noble realised access to best practice advice when diagnosing and treating suspected cancer is often difficult and requires focused reading and education. Summaries of the NICE NG12 cancer guidance are usually A4 sheets with text or difficult to follow infographics, for example, the BMJ spaghetti diagram. Previously, no tool existed that could be used to support GPs without disrupting consultation.

The Bright Idea

Dr Noble, of Woodbrook Medical Centre created mind maps, the ‘Cancer Maps’. These are an interactive online tool based on the NG12 cancer guidelines. They are designed to be used during consultations to help clinicians assess possible cancer symptoms. The maps are easily used during consultations, with the patient present, and can inform the user of the direction their consultation must take. 

There are four main ways to use the maps:

  •  As a quick reference to NICE guidance
  • As a decision support tool
  • As an educational tool
  • With patients to reassure or safety net

 Dr Noble created the mapping by using iMindMap software. With the help of his father, who created the search and web-enabling function.

Dr Noble’s time was covered in part by Cancer Research UK, West Leicestershire CCG and the East Midlands Cancer Alliance.

Not only is this tool relevant across England, it can be easily changed, with changes in guidance. This idea can be applied to several other specialities, for example, diabetes, respiratory conditions or cardiology.

The Impact

A pilot evaluation was carried out in September 2017, where GPs were invited to test the tool. The pilot involved 37 GPs who used the tool 108 times during the four-month period (number of uses per GP ranged from 1 to 7). 34 GPs had used the tool and responded to the end of study survey. The great majority of GPs (94%; 32/34) indicated they would recommend the tool to other healthcare professionals.

The Cancer Maps are an effective, popular interactive reference tool for GPs. The frequency of their use by GPs in the pilot demonstrates a need for awareness and education about cancer guidelines for health professionals. Users overwhelmingly felt their knowledge of the cancer guidelines had increased because of using the tool and felt more confident when making cancer referrals. More than half of users made referrals (best on best practice) which they otherwise would not have done.

It is likely that similar interactive mind mapping tools have further uses in medicine beyond cancer.

The Cancer Maps Webinar

On 11 March 2020, the College will host a free webinar on the Cancer Maps, led by Dr Noble. Participants in the webinar with learn:

  • How to use The Cancer Maps to help identify patients who present with potential cancer symptoms
  • How Dr Ben Noble went about developing and then implementing The Cancer Maps and his experiences from these processes
  • How to use a The Cancer Maps-style approach in different clinical contexts

There will also be an opportunity for a question and answer session. The one-hour long webinars can be accessed via your computer or tablet and are open to all (but particularly relevant for GPs and wider general practice teams). Register here. 

RCGP Bright Ideas

The RCGP recognises and celebrates GPs their teams, practices and patients who come up with ideas to improve efficiency and improve workload through the RCGP Bright Ideas Awards. They are part of the College’s Bright Ideas project – an online platform where people can share ideas for small changes that can have a big impact on general practice. You can submit your Bright Idea by emailing the Bright Ideas Project Team.

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