GP Contract Enhanced Services Primary Care Networks

The Network Early Cancer Diagnosis service – a summary

Breast screening

The Network DES Early Cancer Diagnosis service is due to start next month. Pulse Intelligence outlines what the service entails and relevant guidance.

The Early Cancer Diagnosis service is one of three Network DES services due to start officially from 1 October, having been at least partially delayed due to Covid. (NHS England was still encouraging practices to start work on elements of the service where possible, but the requirements will kick in from next month.)

The service is aimed at delivering on key commitments in the NHS Long Term Plan to improve cancer outcomes – namely to increase the proportion of cancers diagnosed early (stage 1 or 2) to 75% by 2028, and from then on to ensure 55,000 more people each year survive at least five years after diagnosis.

Details of the requirements are outlined in the Network DES specification; there is also a dedicated guidance document for the service.

What are the requirements?

From 1 October 2020, a PCN is required to:

  • Review referral practice for suspected cancers, including recurrent cancers. This means reviewing all practices’ referrals for suspected cancer, against the recommendations of NICE Guideline 12 and making use of: clinical decision support tools; practice-level data to explore local patterns in presentation and diagnosis of cancer; and where available the Rapid Diagnostic Centre (RDC) pathway for people with serious but non-specific symptoms. (Further details on the RDC strategy are available here. Assessment pathways for specific cancers are published here.)
  • Build on current practice to consistently monitor patients who have been referred urgently with suspected cancer, or for further investigations to exclude the possibility of cancer (‘safety netting’), in line with NICE Guideline 12; and
  • Ensure that all patients are signposted to or receive information on their referral including why they are being referred, the importance of attending appointments and where they can access further support.
  • Contribute to improving local uptake of national cancer screening programmes. This means working with local system partners – including the Public Health Commissioning team and Cancer Alliance – to contribute to local efforts to improve uptake, which must include at least one specific action to engage with a patient group with low uptake locally.
  • Establish a community of practice-level clinical staff to support delivery of the requirements. Through this ‘community of practice’ the PCN must: conduct peer to peer learning events, looking at data and trends in diagnosis across the PCN, including cases where patients presented repeatedly before referral and late diagnoses; and engage with local system partners, including Patient Participation Groups, secondary care, the relevant Cancer Alliance, and Public Health Commissioning teams.

Further details and links to supporting organisations and relevant information to support practices in delivering the requirements are provided in the guidance document.

Guide URL:
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