CRUK GP clinical leadership programme

Dr Pawan Randev

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In 2019-20, CRUK funds 17 GPs across 15 Cancer Alliances. They all focus on cancer early diagnosis and work in an integrated way with the CRUK facilitator teams: together they have robust engagement mechanisms with primary care.

CRUK supports a vibrant ‘community’ of CRUK GPs with peer support and challenge, and the sharing of best practice.

CRUK has invested in a clinical leadership development programme to further enhance the impact of the CRUK GPs.

Overview of the CRUK GP clinical leadership programme

The CRUK GP clinical leadership programme aims to:

  1. Provide strategic primary care clinical leadership and educational resource at regional level
  2. Support Cancer Alliances in improving cancer pathways and reducing variation in care provision through the sharing of best practice and innovation
  3. Enhance CRUK’s engagement with and influencing of primary care and national decision making in a systematic way

Northern Cancer Alliance

Dr Chris Tasker
Dr Katie Elliott

Lancashire and South Cumbria Cancer Alliance

Dr Neil Smith

Cheshire and Merseyside Cancer Alliance

Dr Debbie Harvey 

Greater Manchester Cancer

Dr Sarah Taylor 

West Yorkshire and Harrogate Cancer Alliance

Dr Matt Kaye

South Yorkshire and Bassetlaw Cancer Alliance

Dr Steph Edgar

West Midlands Cancer Alliance

Dr Jim McMorran

East Midlands Cancer Alliance

Dr Ben Noble

East Midlands Cancer Alliance

Dr Pawan Randev

East of England Cancer Alliance

Dr Pete Holloway

Transforming Cancer Services Team, London

Dr Lance Saker

Thames Valley Cancer Alliance

Dr Anant Sachdev

Kent and Medway Cancer Alliance

Dr Tina George

Surrey and Sussex Cancer Alliance

Dr Chrissie Clayton

Somerset, Wiltshire, Avon and Gloucestershire Cancer Alliance

Dr Sadaf Haque

Peninsula Cancer Alliance

Dr Joe May


  • Baseline survey indicated patchy education across the CA footprint for primary care. Secured funding and now scoping education strategy. Appointed as clinical lead
  • Established a good partnering relationship with East Midlands Deanery
  • National roll out of Gateway C and development of module on “How to improve the quality of your referral” in response to secondary care reporting poor quality referrals affecting 62 day performance
  • GP education to raise awareness of the qFIT test made available for primary care for symptomatic patients and reiterating the difference between this test and the screening FIT

NG12 implementation and learning events

  • Cancer Maps online tool now sits on the Gateway C website and are now the most visited site on Gateway C. Recorded a series of educational case studies which will sit alongside it. Oral presentation at RCGP conference in Glasgow. Good regional media coverage; meeting with shadow SoS for health, Jon Ashworth.
  • Promoting SEA analysis cross the Alliance, with individual feedback to practices on the submitted cases

Wider primary care involvement in ED, prevention/primary are representation on Expert Advisory Groups

  • Restarted meetings of the Peninsula Prevention and Early Diagnosis Group, with community focus. Attendees from LPC, LOC and PHC. Scope: improving screening uptake, and opportunistic identification of signs and symptoms
  • Formation and chairing of the primary care EAG for the West Midlands and ensuring each cancer site EAG has a GP representative, so that all developments have a primary care a voice

FIT symptomatic implementation

  • Chairing the FIT working group(s) and mobilisation across the Cancer Alliance footprint(s)
  • Negotiations with the LMC, Acute Providers, CCG, and also required a variety of means of communication with the GP community
  • Electronic requesting of FIT according to NICE criteria with safety netting of request by bowel screening hub. The conversion rate for positive tests is currently 23% of requests
  • Developed an Integrated Lower GI Pathway across Alliance footprint and presented this at a National Cancer Alliance conference, and locally at GP education events  
  • Getting NICE guidance into practice in a timely and consistent manner
  • Created London-wide FIT steering group; agreed pan-London approach; secured endorsement from London Cancer Commissioning Board (CCB); developed modelling and business case for use by local commissioners and providers; provided expert support to STPs / CCGs to implement this approach
  • Developed modelling of expected endoscopy and FIT laboratory demand for London that has been adapted for use at national level by CADEAS
  • Already yielded early stage diagnosis of cancer in several patients, only a few months after launch. Take-up of the test is variable and we are examining how to address this
  • Equitable system now in place for all patients and GPs. Standardised analysis and quality controls. Built in evaluation system where all tests and outcomes will be reviewed

Lung health checks

  • Led on information sourcing and meeting with localities who have already undertaken the Lung Health checks ahead of the NHSE announcement of pilot sites, which we are one of
  • Working with STP with respect to the planning of the lung cancer screening pilot which will be based in Coventry
Pathway transformation
  • Produced a map-infographic of the NOLCP to improve understanding of a complex pathway
  • Development of NSCS pathway for patients/piloting of vague symptoms clinics
  • Negotiation of a STT rather than DA model for upper GI cancers


  • Are experienced clinical leaders who are practising primary care clinicians and understand both primary care and secondary care interface issues
  • Have high levels of credibility amongst their peers: their input into planning can provide endorsement to the wider GP community
  • Lead regular primary care reference groups across the Cancer Alliance footprint, thus able to disseminate key messages and seek feedback from grass-roots GPs; supporting Cancer Alliance/NHS England engagement activities
  • Come from diverse backgrounds- in addition to the GP role - e.g. BMA Council, LMC, public health background, GP appraiser, QI lead, CCG clinical lead, Mac GP, IT interests, innovative education delivery, evidence review background
  • Are geographically spread across England and can inform discussion regarding variation and able to share good practice/challenges and avoid reinventing the wheel

Impact of the CRUK GP clinical leadership programme

An independent evaluation of the CRUK GP programme carried out in 2017 found that

  • The CRUK GPs have been involved in driving change, implementing QI and piloting innovation
  • There is a pressing need for GP representation at strategic level
  • The GPs have been effective in driving quality improvements and supporting the implementation of these changes throughout large and complex geographies
“… 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.” – Cancer Alliance Manager

Feedback from host managers and beneficiaries during the 2017 independent evaluation of the CRUK GP programme was unequivocal.

Cancer Alliance Managers really value the strategic input of the CRUK at Cancer Alliance Board discussion and decision-making: 

"Ensures the GP voice is heard early in programmes of work - which prevents or counters resistance." - SWAG
"I would recommend that a GP sits on the Alliance Board and relevant sub group as it is crucial that primary care is represented." - Kent and Medway
“...a GP should most definitely sit on the Alliance Board – the Cancer alliance is not just about secondary and tertiary care – primary care are equal players and need to have a voice."- Lancashire & South Cumbria
"The CRUK GP has made an impact with really robust and strong messaging in relation to NG12, Vague Symptom provision and the FDS (28 day standard)."- Kent and Medway
"Having a board level GP has helped … this ensures that messages and key information gets communicated out to their GP colleagues."- SWAG
"Having primary care involvement on both the Exec Board and Delivery Group has been hugely helpful particularly when much of the focus has been on 62 day performance. It ensures that the conversation isn’t solely focussed on secondary care."- Kent and Medway 
"Our GP leads are in regular contact with our CCG Lead GPs, Macmillan GPs and other GP leads across the Alliance. This creates a cohort and critical mass of opinion that gives us confidence that we have understood and included the various perspectives from primary care in our work."- Peninsular
"They influence our priorities by being integrated at a number of levels."- Northern

CRUK GP community of practice

CRUK staff service the CRUK GP ‘community of practice’ which provides an excellent networking and sharing opportunity for the GPs, and is highly valued by the GPs  and their respective Cancer Aliances: 

"Heterogenous, approachable, innovative and generous group with wide ranging experience and ideas. The benefits are enormous. You ask a question and will receive a multitude of replies. Some will agree and some may not but all comments and thoughts are shared in a very supportive, non-threatening environment."

"Working with other CRUK GPs at the leadership sessions helped provide an excellent insight into my own leadership qualities. This has helped me to contribute more confidently during meetings and other interactions pertinent to my role."

"Learning from regular email streams on cancer pathways in other regions, FIT, FDS & MDCs."
"The community of GP’s can provide a wide depth of knowledge and insights which helps us develop a clear unified message."

"Sharing of problems, gaining from other’s experience."

"I feel less alone – and I find many of my fellow CRUK GPs quite inspirational!"
"I enjoy our days together and much prefer the larger national groups where there is more expertise and varied opinion. I think it is wonderful that when any one of has a question or problem they can put out a request. A creates flurry of suggestions and sets off a debate that Patricia later collates."
"The support when things are tough has been great.  There has nearly always been someone else who has previously struggled with an issue and we have all really helped each other out and made great suggestions of solutions."
"It has been great – peer support, knowledgeable colleagues, sharing uncertainties, learning (and copying) influencing techniques, being there for colleagues at their times of uncertainty, keeping up to date, being challenged by the achievements of others and realising we could do that too."
"The range of experience and approach among the CRUK GP community hugely useful and it is a privilege to be in the company of some GPs who are clearly influencers on a national level."
"The leadership programme helped develop my skills and resilience to be an effective CRUK GP."

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