CRUK North Wales Facilitator Jan 17 Draft V3

SEA Follow up Action Plan:

Theme / Issue / Action / Lead / Contact / Progress Jan 17
Cancer data / Availability of screening data / cancer data for practices. / Provide practices and clusters with available Cancer data during practice visits and cluster meetings.
Agree any relevant practice and cluster actions.
Circulate cancer data web links to practices. / Kate Newman / Clusters to continue to receive cluster screening data via PHW but with recommended actions as to how clusters can increase uptake. Actions to be included in cluster plans.
Discussions ongoing with potential agreement for CRUK facilitator to receive an agreed data set at practice / cluster level to help inform action planning and prioritizing.
Access to diagnostics / Reported delays where straight to test is not available. / Direct referral to colonoscopy being piloted in central.
Consideration for a pilot in East / Caroline Williams
Hayley Crumpton / Commitment from Planned Care to roll out straight to test on all 3 sites in 2017/18
Variations in availability of ‘straight to test’ across 3 sites. / Follow up with Radiology at YG regarding direct access to CT (as available in East and Central) / Caroline Williams / Discussions with Radiology ongoing
Referral systems / processes / Use of WCCG, not always able to record information as required on system. / Identify if any practices not using WCCG and if use of system is a wider problem. Provide guidance (if required) on effective use of WCCG for cancer referral.
Gain further understanding of use of WCCG in secondary care – (are written referrals accepted) / Kate Newman / This was highlighted as an emerging theme in 2014. Will explore further if theme repeats for 2016 (GP contract SEA work)
Variation in forms / templates / PCQ requirement is confusing and contributes to delay / Colorectal advisory group meeting 30th November and will review PCQ.
Guidance to practices agreed and communicated re: PCQ completion by patient. / Caroline Williams
Hayley Crumpton / To be reviewed as part of the roll out of straight to test in 2017/18 as per item above.
Referrals are downgraded with limited communication back to GP / Work underway with urology and colorectal in east to improve communication with downgraded referral.
To be replicated across central and West.
Ongoing audit of downgrades which result in a cancer diagnosis / Caroline Williams
Hayley Crumpton
Caroline Williams / Cancer standards monitoring in 15/16 shows East and West compliant with informing GPs of downgrades. East piloting new downgrade form in urology and colorectal which informs GP of reason for downgrade – to be rolled out across Health Board
Urology patients lost to follow up / CST has submitted funding application to purchase PSA tracker software.
Or
Consideration to develop a LES for PSA in practice / Caroline Williams
Hayley Crumpton / Awaiting outcome of funding applications
Clinicians to keep up to date with NICE guidelines / Provision of NICE referral publications
Delivery of education session on pathways and NICE guidance
Link to Cancer network clinical guidance project via Cliff Jones (Macmillan) / Kate Newman
Kate Newman / Hayley Crumpton / NICE implementation a QOF requirement for 2017. A number of support sessions to be arranged in 2017 with practices to review if / how NICE cancer referral guidance is being implemented in practice
Screening / Communication about patients with positive FOBt attending gastro referral. Communication between BS hub and practices / Review current position of communication mechanism between practices and BS hub. Work with practices re non responders and follow up of referrals.
Review current position of screening link person programme in North Wales practices. / Kate Newman / Significant developments to be implemented in 2017 from BSW which will improve communication between practices and hub about patience. CRUK, BSW and PHW have agreed to work in partnership on a number of evidence based approaches aiming to increase uptake.
In 2016 a series of bowels screening awareness sessions have taken place with practices and other community health staff.
Patient Factors / Patients presenting late in primary care / Link to Wales Cancer network plans to deliver public awareness campaign in 2017.
Provide community health settings with public resources on signs and symptoms / Kate Newman / CRUK public resources have been disseminated widely across North Wales.
Waiting to hear cancer network plans for public awareness campaigns and will link in / support implementation.
Working with Pathways and performance manager to explore further emergency presentation audit undertaken for central division.
Patients not attending USC referral appointment and it not flagged up as a priority DNA with primary care / Review and change wording in DNA letter for USC to flag to primary care to follow up as urgent with patient. / Caroline Williams / Health Board to review CRUK ‘understanding your urgent referral’ public leaflet, which could support this work at practice level by encouraging patients to attend appointment
Communication between primary and secondary care / Lack of point of contact for advice for referrals / Consider developing primary care advice hub. Look at examples in South Wales. / Kate Newman
Hayley Crumpton / Quarterly communication brief to be circulated to primary and secondary care. Will include information about both primary and secondary care and is available to anyone to provide relevant content.
First communication to be circulated by end of Feb 17

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