GP Contract 2022/23 and cancer: A guide for Primary Care Networks

In the 2022/23 PCN DES, there have been some updates to the Early Cancer Diagnosis service requirements. These are:

• 8.5.1
  • A. Review referral practice for suspected and recurrent cancers, and work with its community of practice to identify and implement specific actions to improve referral practice, particularly among people from disadvantaged areas where early diagnosis rates are lower;
  • B. Work with local system partners– including the NHS England and NHS Improvement Regional Public Health Commissioning team and Cancer Alliance – to agree the PCN’s contribution to local efforts to improve uptake in cervical and bowel NHS Cancer Screening Programmes and follow-up on non-responders to invitations. This must build on any existing actions across the PCN’s Core Network Practices and include at least one specific action to engage a group with low participation locally;
  • C. Work with its Core Network Practices to adopt and embed: i. the requesting of FIT tests where appropriate for patients being referred for suspected colorectal cancer; and
    • ii. where available and appropriate, the use of teledermatology to support skin cancer referrals (teledermatology is not mandatory for all referrals).
  • D. focusing on prostate cancer, and informed by data provided by the local Cancer Alliance, develop and implement a plan to increase the proactive and opportunistic assessment of patients for a potential cancer diagnosis in population cohorts where referral rates have not recovered to their pre-pandemic baseline; and
  • E. review use of their non-specific symptoms pathways, identifying opportunities and taking appropriate actions to increase referral activity.

Support from Macmillan

The following resources will help you to meet the early cancer diagnosis requirements.

Quality improvement modules

Our early diagnosis and cancer screening modules will help you identify patients at risk of cancer, increase uptake of cancer screening and improve referral practice.

Video mini-series

We have created a mini-series of short videos, featuring CRUK GPs and Macmillan GPs sharing their tips and advice for delivery of the PCN DES specification for early cancer diagnosis.

Patient information

We have information for patients about going for tests to help manage expectations and allow them to explore the process at their own pace.

Cancer Decision Support tool

Our Cancer Decision Support (CDS) tool can be accessed from EMIS Web, INPS Vision, TPP SystmOne. We have created a series of videos on how to use the tool most effectively. There is also written guidance available.

The updates to the PCN DES Around personalised care are as follows, and focus on social prescribing-community development.

8.10.1 – By 30 September 2022, as part of a broader social prescribing service, a PCN and commissioner must jointly work with stakeholders including local authority commissioners, VCSE partners and local clinical leaders, to design, agree and put in place a targeted programme to proactively offer and improve access to social prescribing to an identified cohort with unmet needs. This plan must take into account views of people with lived experience.

8.10.2 – From 1 October 2022, a PCN must commence delivery of the proactive social prescribing service for the identified cohort. Macmillan has created resources on social prescribing to support people living with cancer, which include: Social prescribing guidance for primary care and our 10 Top Tips for primary care: Social prescribing.

8.10.3 – By 31 March 2023, a PCN must review cohort definition and extend the offer of proactive social prescribing based on an assessment of the population needs and PCN capacity. Shared Decision Making (SDM) on page 63.

8.10.4 – By 30 September 2022, a PCN must ensure all clinical staff complete the Personalised Care Institute’s 30-min e-learning refresher training for Shared Decision Making (SDM) conversations on page 67. Macmillan has created 10 Top Tips for shared decision making in primary care and people living with cancer.

8.10.5 – By 31 March 2023, a PCN must audit a sample of the PCN’s Patients’ current experiences of shared decision making through use of a validated tool and must document their consideration and implementation of any improvements to SDM conversations made as a result.

We have created guidance for personalised care and social prescribing to help you navigate these requirements. You can also download our quality improvement module for personalised care.