Be Clear on Cancer: How GP practices can speed up diagnosis

As the Be Clear on Cancer campaign relaunches its Blood in Pee awareness message, Redbridge GP Dr Jyoti Sood writes for GPonline about primary care clinicians' role in early diagnosis, and in an exclusive video talks about her own family's experience of cancer.

We often see the more negative press stories about the NHS dominating the headlines, so it is nice to see some promising news. I recently saw some data, presented by Luke Hounsome from Public Health England, for the first national Be Clear on Cancer campaign for ‘Blood in Pee’ which ran in autumn 2013. It showed that over the campaign period there was an increase in early stage bladder cancer and a reduction in late stage disease.

There was an increase in early stage kidney cancer, but no change in late stage disease. They also identified additional cases of CIS and pTa and in their analysis estimate that detection of early stage disease and pre-malignant disease equated to the prevention of around 70 bladder cancer deaths and about 25 kidney cancer deaths. While it’s not possible to absolutely link these findings to the campaign, it’s highly likely that the campaign had made a difference.

As I am sure many of my GP colleagues have experienced in recent years, the thought of a marketing campaign at a time when we are already under pressure and struggling to fit everything into the day can feel a little daunting. However, news like this certainly gives me hope that we are moving in the right direction and our efforts are starting to show promise.

Be Clear on Cancer

For me, the Be Clear on Cancer campaigns are an opportunity to show the full primary care team that they have a role to play in diagnosing cancer earlier. It doesn’t all sit on the GP’s shoulders. In my practice and CCG, we talk to reception staff and help them think about the things to look out for – such as women from ethnic minority groups who may refuse some appointments because they want to see a female GP from a similar ethnic background.

Or, the difficulties that some of our elderly patients experience, such as those with visual impairments who may be worried about how they check for signs of cancer. It can be a challenge for our practice teams but we must work hard to ensure these sorts of things aren’t a barrier to the patient presenting promptly. Community matrons, pharmacists, practice mangers and health care assistants are just some of the other groups that I work with as the cancer lead for our CCG.

It doesn’t have to be complex solutions - just the way in which the practice manager and reception team triage calls and our post can have a big impact. As for GPs, well during our entire career, we are only likely to see a small number of bladder and kidney cancers, so pooling the learning from each case of urological cancer in our practice can be really beneficial, and we use the significant event audit process to help us see if we could have done anything differently.

A new ‘blood in pee’ campaign is about to launch (15 Feb until end of March) and I am currently checking with colleagues in my practice and the wider CCG to make sure they have tools to help them quickly refer to the new NICE guidance, that they make the most of CPD modules that exist and get their practice teams ready.

The challenge of keeping abreast of all the latest evidence whilst managing our daily practice lists seems impossible at times – but I do try to help colleagues across our CCG with that. Each practice/CCG will be different and we will all have our own ways of coping and adapting to the next campaign to appear on our TV screens. But I hope, like me, that you find this latest data on stage of disease encouraging.

My granddad always used to teach us the ‘stitch in time’ idiom as we were growing up – it was tragic to hear just before he passed away from bladder cancer that he wished he had taken his own advice and acted early. I just hope the Be Clear on Cancer campaign will help others to make a stitch in time.

  • Dr Jyoti Sood is a GP and cancer lead for Redbridge CCG

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