10 Top Tips: Cancer Safety Netting

Welcome to Macmillan's guide on Cancer Safety Netting in Primary Care. Get our top 10 tips to help you better understand how to apply cancer safety netting in your practice.

Our tips are here to help you with everything from communicating with your patients to using digital systems for better tracking.

1. What is safety netting
2. How to apply safety netting in daily practice
3. Effective patient communication in safety netting
4. Improving patient understanding for effective safety netting
5. Communicating referrals with your patient
6. How to manage 'normal' test results
7. Digitalisation: the future of cancer safety netting in primary care
8. Integration of electronic safety netting systems in primary care
9. Addressing diagnostic uncertainty
10. Demonstrating safety netting skills for Primary Care Network DES
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1. What is safety netting

Safety netting can be broad in its definition but in summary, it is an essential process to help manage uncertainty in the diagnosis and management of patients. This is done by providing clear information and organising a follow-up after contact with a health professional.

2. How to apply safety netting in daily practice

Safety netting is often applied differently in practice. It is important that healthcare professionals understand and apply the basic aspects of safety netting in daily practice. The rigour applied to safety netting is often tailored to a patient’s needs and the clinician’s concerns.

3. Effective patient communication in safety netting

Communication to the patient is a central part of safety netting. Key aspects to cover with patients include:

Communicating uncertainty and being explicit and clear about this
Advice on red flags or worrying symptoms that should trigger an action
The likely time course of the illness, ensuring specific time frames are given
How and when to seek further review or re-present if symptoms persist or get worse.

4. Improving patient understanding for effective safety netting

Consider a range of actions to support patient understanding - this can help the patient to feel more empowered. Verbal advice can be supported by sharing patient information leaflets and/or using SMS or email to share information digitally.

5. Communicating referrals with your patient

At the point of referral for an investigation or an Urgent Suspected Cancer pathway, communicate the rationale for the referral to the patient, ensure the patient’s contact details are up-to-date and explain what to expect and what to do if no communication is received regarding the appointment or the result of a test.

6. How to manage 'normal' test results

A pitfall in diagnostics is the “normal” or ”negative” result. Another aspect of safety netting is when a test is reported as normal, yet the patient continues to have symptoms. It is important to tell patients that, even if their test results come back as “normal”, they should continue to seek medical attention if they keep having symptoms.

7. Digitalisation: the future of cancer safety netting in primary care

Primary care teams should have robust, digitalised methods of safety netting in place. Many practices are now using electronic systems which operate best with whole practice engagement, clear leadership, and explicit processes in place.

8. Integration of electronic safety netting systems in primary care

Electronic safety netting systems work effectively if integrated into the GP electronic healthcare systems and use the coding system to capture specific events to be followed up and tracked. The systems should highlight concerns, such as patients who have not attended their appointments or tests. There should be clear protocols in place to address these situations.

9. Addressing diagnostic uncertainty

Diagnostic uncertainty is part of general practice and is to be expected, especially when patients present with vague symptoms. Roger Neighbour, the celebrated British general practitioner (GP) and educator in the field of communication in primary care, used the phrase ‘How will I know I’m wrong?’ to refer to this element. This can be used as the basis for the ‘in-consultation’ elements of safety netting that rely on clear and transparent communication between the healthcare professional and the patient.

10. Demonstrating safety netting skills for Primary Care Network DES

Safety netting is an essential requirement in the Primary Care Network DES, so following these tips and being able to demonstrate subsequent learning and actions will be useful evidence to show that your PCN has achieved this element of the DES.

More useful resources for primary care

About our information

Written by Dr Anthony Cunliffe

Next planned review: July 2023

We make every effort to ensure the information in these pages is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement. Or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular check any drug doses, side-effects and interactions. Save insofar as any such liability cannot be excluded at law, we do not accept any liability in relation to the use of or reliance on any information contained in on this page, or third-party information or websites referred to in them