Early Diagnosis of cancer: Guide to the GP Contract 2020/21 for PCNs and Practices

GPs play a pivotal role in diagnosing cancer earlier and supporting the NHS Long-Term Plan ambition to diagnose 75% of cancers at stage 1 or 2 by 2028.

The aim of this information is to support GP practices and PCNs to deliver on their GP contract requirements for the early diagnosis of cancer. See the GP contract requirements for 2020/21

"CRUK has a wealth of expertise and experience in both promoting early diagnosis and primary care engagement, so is ideally placed to help PCNs deliver their cancer agenda." - Dr Pete Holloway, CRUK GP and PCN Clinical Director in Suffolk.

These GP contract webpages and the recommendations have been developed with our team of CRUK GPs. The CRUK GPs are all practising GPs, as well as being involved in more strategic work across their respective Cancer Alliances.

How the early diagnosis of cancer features in the GP contract 2020/21

The Supporting Early Cancer Diagnosis specification says PCNs will:

  1. Improve referral processes for suspected cancers, with a focus on safety netting, ensuring that all patients receive information on their referral
  2. Contribute to improving local uptake of National Cancer Screening Programmes working with local system partners
  3. Support the delivery of 1) and 2) through a community of practice which supports peer to peer learning events, and engagement with local system partners

The overarching objective of these QI indicators is to contribute to improvements in relation to the following aspects of care:

  1. Participation in national breast, cervical and bowel cancer detection and prevention screening programmes among a practice’s registered population
  2. Referral practices for patients suspected of having cancer; including use of guidelines, professional development, safety netting of those referred on suspected cancer pathways and shortening of diagnostic intervals

The NHS has a stated ambition in the Long Term Plan that, by 2028, the proportion of cancers diagnosed at stages 1 and 2 will rise from around half now to three-quarters of cancer patients. Achieving this will mean that, from 2028, 55,000 more people each year will survive their cancer for at least five years after diagnosis. Primary care has a vital role to play in delivering this ambition, working closely with wider system partners including Cancer Alliances, secondary care, local Public Health Commissioning Teams and the voluntary sector.

In January 2019, NHS England and the BMA released a 5 year framework for GP contract reform to implement the NHS Long Term Plan.

The QOF Quality Improvement (QI) module on cancer early diagnosis, and the Primary Care Network (PCN) early diagnosis of cancer specification both recognise the pivotal role that GPs play in diagnosing cancer earlier and support the NHS Long-Term Plan ambition to diagnose 75% of cancers at stage 1 or 2 by 2028, an increase from just over half now.

With a focus on screening uptake, referral practices (and audit e.g. the National Cancer Diagnosis Audit) and safety netting, they encourage quality improvement at individual practice level, as well as across the PCN and wider system.

"CRUK has a wealth of expertise and experience in both promoting early diagnosis and primary care engagement, so is ideally placed to help PCNs deliver their cancer agenda." - Dr Pete Holloway, CRUK GP and PCN Clinical Director in Suffolk.

This GP contract hub aims to help practices and PCNs deliver on these GP contract requirements.

Dr Debbie Harvey, CRUK GP recommends the following top tips:

  1. Make sure you check what is taking place (or being planned) locally before you embark on your own planning and actions, so you don’t reinvent the wheel
  2. There may be specific cancer working groups which bring together relevant stakeholders that you could tap into
  3. Support will be available from a range of organisations including your local CCG, who can help co-ordinate activities, to avoid working in silos
  4. Make sure you link in with your local Cancer Alliance and public health teams who will likely have local plans and resources to support you.
  5. Your area may already have a CRUK Facilitator, CRUK GP, Macmillan GP or other cancer lead who will be aware of specific work around cancer which might support you and avoid unnecessary effort and duplication
  6. CRUK is well placed to help practices/PCNs, and it should be noted that CRUK is an integral part of the support system for GPs and PCNs