Cancer Create session

Cancer

Facilitator: Lead cancer GP

Prior to the session:

1.     Ask Dr Paul Baughan (Health Board cancer lead) for general background information or slides about cancer care within NHS Forth Valley and specific information about your own GP practice referral rates (and how this compares with other GP practices).

2.     Lead GP within your practice to review this information prior to the session to consider the main learning points and how best to use this information.

3.     Practice Manager to pull details of last 10 cancer diagnoses within the practice and then discuss with the lead GP within the practice which ones have the greatest potential to learn from.

During the session:

4.     Outcomes – whole team discuss what you want to get out of session (15 mins) eg

a.     Improve cancer referrals

b.     Be alert to referral guidelines

c.     Consider after diagnosis GP care

5.     Review of Current Processes – (30mins)

a.     Consider your most recent 4 or 5 cancer diagnosis and map the process from pt presenting to diagnosis

b.     Review the referral guidelines for these tumour groups

c.     Consider what happens within primary care after diagnosis. 

d.     Look at cancer letters from secondary care – does this provide you with the info you need?

6.     Identify Risk Areas (pitfalls) – consider your current processes - (30 mins)

a.     Was an adequate history and examination obtained and documented?

b.     Were there any patient induced or practice-induced delays in the diagnostic process?

c.     Was appropriate use made of any direct access to diagnostics, and if so does the GP practice have a clear policy for informing patients the results of practice-initiated investigations? 

d.     Were the referrals in line with the guidelines?

e.     Do you have a system to ensure that all patients with a new diagnosis of cancer are reviewed?

Break (15 mins)

7.     How to Improve Processes – (30 mins)

a.     Can Drs refer directly via gateway after the consultation?

b.     Is it worth waiting for bloods or investigations before making referral?

c.     Do you make pt aware of your cancer concerns and what will happen to them

d.     Do you give any information leaflets?

e.     Are you over using the cancer pathways? – Why is this – r/v recent referrals which have not turned out to be cancer – were they appropriate?

f.     When you are notified of new diagnosis – how soon after do you see the patient – what areas do you cover when you see them eg. Understanding of Dx, management plan, impact on existing lifestyle, how do they feel, anticipating needs etc. 

8.     Summarise

a.     r/v outcomes (did you achieve what was in 1)

b.     will you change the way your practice works?

9.     Evaluation

a.     What have you learned today?

b.     What are you going to do now, as result of this session?

c.     And by when

d.     When should you do this session again (perhaps pencil in for another create session in 1-2 years)

TIPS

·     Include district nursing staff

·     Get 2 neighbouring practices together to share ideas & compare stats