Dr Anant Sachdev Dr Anant Sachdev is a full-time GP in Bracknell, Berkshire, Cancer Lead for the Thames Valley Cancer Alliance on Prevention and Early Diagnosis, CRUK Strategic GP, Cancer Lead & Specialist in Palliative Medicine in Berkshire and a Senior Appraiser. He has also developed strategy and guidelines locally for Federated Clinical Commissioning Groups in in various fields of Medicine, including Cardiology, Urology and Dermatology. With a passion for education, Anant has worked with Macmillan, CRUK and NHS England on various programmes including Cancer Masterclasses, National Awareness and Early Diagnosis Initiatives in Cancer, as well as the current “Be Clear on Cancer” programme.

Quality Improvement Scheme

(QIS)

Supporting Primary care professionals to improve earlier

diagnosis of cancer

Dr Anant Sachdev (Joint SRO – QIS)

4 October 2018

Outcomes/benefits of the QIS

• Earlier diagnosis of cancers • Annual increase in cancers diagnosed at stages 1&2

• Increased proportion diagnosed through the appropriate

pathway - 2WW

• Improved screening uptake - Breast, Bowel and Cervical • Identify groups of patients who do not take part in breast,

cervical or bowel screening • Support primary care to proactively encourage patients to

take up the national cancer screening programmes

The QIS conception

Developed a QIS Working Group

• Provide TVCA-oversight of activities for screening uptake for breast, bowel and cervical cancer

• Includes:

• CCG Cancer Leads • TV Screening and Immunisation team • PHE • Macmillan and CRUK partners • Local authority partners

• Promote collaborative working to share best practice and learning from

current improvement activities

• Support development of the QIS toolkit

The NHS ….reinvent the wheel???? … never!

Finding evidence-based resources

QIS Toolkit • A downloadable resource for all GP practice team members, both

clinical and non-clinical • Provides relevant links to a variety of information and resources

including best practice guidance and evidence-based interventions to help increase screening uptake (for breast, bowel and cervical) and support improvements in cancer diagnosis via the 2ww pathway

• Makes information easily accessible in one central place

• Can be downloaded from Thames Valley Strategic Clinical Network

website:

http://tvscn.nhs.uk/networks/cancer/quality-improvement-scheme-qis-toolkit-for-primary-care/

QIS Toolkit – Final product

Thame Valley Cancer Alliance Early Diagnosis QIS Toolkit

Patient information

Screening guidance

Improving uptake of

cancer screening

Referral guidance

Safety netting

Quality improvement

activities

Data Education and

training

Awareness campaigns

Key contacts

What was the ask from TVCA?

• All CCGs to sign up to the QIS for 2018-2020

• Work with their local GP practices, local public health teams, CRUK and Macmillan teams

• Develop an implementation plan – How to engage with GP practice teams

– How will use the QIS toolkit to aim to improve screening and 2ww detection rates

• Detailed outlines of the steps each CCG would take, specific actions and the timeline for completion

Challenges: Engagement

• Key delivery partners • Concerns for current pressures on primary care • Collaboration – discussion of barriers and successes

• Using the QIS toolkit

• Incentivisation • Strong communications and marketing approach

• CCG communication teams • CRUK facilitators • Educational events • Newsletter communications

• Use in revalidation and appraisal process

Challenges: Data

• Different timelines for each screening programme • Breast Screening (3 year coverage, %) 50-70 years

• Bowel Screening (2.5 year coverage, %) 60-74 years

• Cervical Screening (3.5 or 5.5 year coverage, %) 25-64 years old

• Time lag for validated data

• Accurate recording of data

• Impact of national decline in screening uptake

Measuring success

• Screening uptake (%) – Breast, bowel and cervical

• 2ww cancer detection (%)

• Data on how cancers have been diagnosed (e.g. via 2ww pathway or emergency presentation routes)

• Adoption of toolkit - e.g. interventions used

• Qualitative feedback on the QIS toolkit (e.g. operability, content, format) – Ongoing feedback process

Where we are now?

• Phase 1 – Nov 2017 – March 2018

• Initial set up of the project

• Creation of a Working group

• Creation of QIS toolkit

• Phase 2 – April to December 2018

• Develop implementation plans and set targets

• Phase 3 – Jan to March 2019

• Ongoing monitoring and evaluation

Useful contacts

• Dr Anant Sachdev (Joint SRO) - Clinical Lead Prevention and Early Diagnosis

Anant.sachdev@nhs.net

• Robert Elvin – TVCA Early Diagnosis Project Manager

Robert.elvin@nhs.net

Thank you.