Strategic GP programme

Dr Pawan Randev

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Since 2014, Cancer Research UK (CRUK) has funded Strategic GP Lead (SGPL) roles within Strategic Clinical Networks (SCNs).

The aim of the CRUK Strategic GP programme is to address gaps in primary care clinical leadership at a regional level across England. The Strategic GPs facilitate change, work across organisational and pathway boundaries, and enable learning, development and action in primary care settings.

Overview of the Strategic GP programme

The SGPL programme has grown incrementally since the first two appointments were made in August 2014.

Strategic GP timeline

CRUK encourages SGPLs to focus their activities on the earlier stages of the cancer pathway i.e. prevention, screening, early diagnosis and access to diagnostics, in line with CRUK’s organisational priorities.

There is considerable variance in how the SGPL role is executed at Network/Alliance level: this variance reflects the diversity of contexts in which SGPLs work, the resources available to them, differing local opportunities, needs and priorities, and individual SGPL interests/expertise. 

However, SGPL activity can be divided into 3 broad categories: driving change, implementing quality improvements, and piloting innovations.

SGPLs:

  • Provide an (otherwise absent) primary care perspective at strategic level
  • Provide clinical insights and understanding to non-clinical managerial teams
  • Improve communication at the primary/secondary care interface
  • Motivate and inspire GP colleagues within their geographies
  • Drive and embed systematic quality improvements at scale
  • Plan and deliver GP educational and training resources/events
  • Develop, pilot and resource innovations in cancer prevention and early diagnosis

Specific outputs include:

  • NG12-compliant suspected cancer referral pathways (implemented across large and complex healthcare geographies)
  • A pan-network timed lung cancer pathway to address the issue of late presentations and delayed access to treatment
  • Gateway C: a comprehensive GP cancer training and resource portal (in conjunction with the Manchester Cancer Vanguard)
  • Suite of web-based resources for commissioners and clinicians on GP direct access to testing
  • A ‘Teachable moments’ programme for patients referred on a 2ww pathway but not diagnosed with cancer
  • ‘Speed dating events between primary and secondary care clinicians
  • Innovations in terms of improving bowel screening uptake

Many of the activities are undertaken through teamwork, with the , and the roles can be highly synergistic: SGPLs add ‘GP credibility’ and strategic influence to Facilitator teams, and Facilitator teams provide invaluable quality improvement and primary care education resource to SGPLs. 

Central CRUK teams are available to support the Strategic GPs bringing additional capacity and expertise, and conversely, Strategic GPs support these teams in their delivery of their programmes of work. Feedback shows that this mutual benefit is highly valued.

Impact of the Strategic GP programme

Background

  • Healthfocus Research was commissioned to conduct a qualitative evaluation of the programme. 
  • The overall aim of the project was to qualitatively evaluate the process and impact of the SGPL programme on stakeholders and health services locally, regionally and for CRUK. 
  • The evaluation comprised interviews with SGPLs, CRUK Facilitator Managers, and a purposive sample of key individuals who work with SGPLs at a local level. Both the functioning of the programme and its outcomes/impact were explored.
  • Where possible, examples of hard outcomes were gathered to triangulate the interview data and enhance understanding of the outcomes and impact of the programme. 

Evaluation Methods and sample

  1. CRUK interviews: Contextualising interviews with CRUK national SGPL Programme Leads.
  2. Stakeholder and SGPL Interviews; Interviews with SGPLs, Host Organisation Managers (Strategic Clinical Network Aliance & London Transfrming Cancer Services Team) and CRUK Facilitator Managers.
  3. Beneficiary Interviews: Interviews with Local Programme 'beneficiaries' (eg GP Education Lead, Consultant Medical Oncologist, Transformation Manager).
  4. Impact data collection: Collection of examples of hard outcome and impact data.
  5. Data anlaysis: Thematic anaysis and data triangulation.

Total interviews n=37

Results

  • The SGPL role falls into 3 categories: driving change, implementing quality improvement and piloting innovation.
  • The area of greatest SGPL impact has been the development and systematic implementation of NG12-compliant suspect cancer referral pathways.
  • The presence of the GP voice at strategic levels was invaluable.
  • There are several examples of hard outcome and impacts.
  • The progress made would not have taken happened without SGPL input.

Conclusions

  • There is a pressing need for strategic GP representative at Strategic Clinical Network/Alliance level
  • The SGPL programme has been effective in driving quality improvements and supporting implementation of these changes.
  • There is a clear case for continued funding of the SGPL role.

See this evaluation as an infographic poster

Feedback from host managers and beneficiaries was unequivocal…

The SGPL programme has been effective in driving quality improvements at Network/Alliance level and supporting the implementation of these changes throughout large and complex geographies.
The presence of a GP voice at strategic level was invaluable.
“… the combination of the research and evidence stuff and the clinical knowledge and the voice of the jobbing GP voice…and the credibility of a clinician to disseminate new evidence based ways of  working … that’s what the SGPLs bring.” - Host Manager

Strategic GP community

In 2017-18, there are 12 Strategic GPs in post across 8 Strategic Clinical Network/Alliance areas. This small ‘community’ of Strategic GP leads keeps in touch with each other and with the wider CRUK teams through:

  • Annual away days
  • ‘Keeping in touch’ quarterly telephone conferences
  • Topic-specific sharing and discussions (linked to areas of common interest)
  • Monthly email update
  • Monthly clinical leadership letter from CRUK Cancer clinical lead, Dr Richard Roope
  • Ad hoc emails
  • Informal networking
  • Attendance at other RCUK events eg Cascade

Last reviewed

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