Guide to the GP Contract 2023/24 for Primary Care Networks (PCNs) and Practices: Early Diagnosis of Cancer and Health Inequalities

Access our free and evidence-based information, including useful tools and resources, to support GPs to deliver best practice in prevention and early diagnosis.

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. Access our free and evidence-based information, including useful tools and resources, to support GPs to deliver best practice in prevention and early diagnosis.

The aim of this information is to support GP practices and Primary Care Networks to deliver on their GP contract requirements for the early diagnosis of cancer and tackling neighbourhood health inequalities. See the Network Contract Directed Enhanced Service PCN specification requirementsSee the Changes to the GP Contract in 2023/24, See Tackling Neighbourhood Health Inequalities guidance for 2023/24

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

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 and health inequalities feature in the GP contract 2023/24

Early Diagnosis of Cancer

Primary care has a vital role to play in system-wide improvement efforts to increase the proportion of cancers diagnosed early, supporting the NHS Long Term Plan ambition to diagnose 75% of cancers at stages 1 and 2 by 2028. The Early Cancer Diagnosis service requirements for PCNs seek to improve referral practice, screening uptake through network level activity, adopt and embed FIT and teledermatology, focus on prostate case finding and review and use non-specific symptom cancer pathways.

Tackling Neighbourhood Health Inequalities

Although health inequalities are largely driven by factors outside of the healthcare system, actions taken within the healthcare system can impact health inequalities. It’s important to note that some actions, such as untargeted health awareness campaigns, can widen health inequalities, so measuring the impact of interventions on health inequalities is crucial.

Health Inequalities impact every part of the cancer pathway including prevalence of cancer risk factors, screening uptake, stage of disease at diagnosis, and access to and experience of treatment, and contribute to stark differences in incidence and outcomes. Primary care has an important role in taking action to identify and address health inequalities.

Whilst the Tackling Neighbourhood Health Inequalities specification is not cancer specific, there are elements within it that can be applied to cancer if a PCN chooses to do so, and we would particularly highlight cancer prevention and cancer screening as areas where action could have a significant impact.

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.


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. Work with your ICS 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 GP or other cancer lead who will be aware of specific work around cancer which might support you and avoid unnecessary effort and duplication