Download HCCG ES05 - Prostate Cancer Specification 2015

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Service Specifications
Mandatory headings 1 – 4: mandatory but detail for local determination and agreement
Optional headings 5-7: optional to use, detail for local determination and agreement.
All subheadings for local determination and agreement
Service Specification No.
Prostate Cancer
Commissioner Lead
HCCG Primary Care Commissioning Lead
Provider Lead
General Practice
1st April 2015 – 31st March 2018
Date of Review
Annual Review
Population Needs
National/local context and evidence base
Prostate cancer is one of the most common cancers in men with approximately 35,000 new
cases in England and Wales and 10,000 deaths. The disease is predominantly associated
with older men but around 20% are men under 65 years of age.
As the incidence of prostate cancer is high and five-year survival rates are around 70%
many men are alive who have been diagnosed with prostate cancer. An estimated 215,000
men are alive in the UK having received a diagnosis of prostate cancer.
Deprivation incidence gradients have been reported for both and England and Wales and
Scotland, with higher rates in the least deprived populations. These deprivation gradients
have widened during the 1990s due to the greater relative increase in incidence for men in
the most affluent groups and are likely to be influenced by accessibility and uptake of PSA
NHS Outcomes Framework Domains & Indicators
Domain 1
Domain 2
Domain 3
Domain 4
Domain 5
Preventing people from dying prematurely
Enhancing quality of life for people with long-term
Helping people to recover from episodes of ill-health or
following injury
Ensuring people have a positive experience of care
Treating and caring for people in safe environment and
protecting them from avoidable harm
Local defined outcomes
Increase in 5 year survival rates for men within Hardwick CCG diagnosed with
prostate cancer
Reduction in under 75 mortality rate for males within Hardwick CCG diagnosed with
prostate cancer
Increase in patient satisfaction in relation to access and convenience
Aims and objectives of service
The aims of this service are to move the care of locally advanced prostate cancer
patients stable on treatment out of the acute hospital and into primary care.
The objectives of this service are to:
Provide routine follow up management of patients with locally advanced prostate cancer
stable on treatment
To identify patients whose disease has progressed and ensure rapid referral back into
secondary care for review
Service description/care pathway
The service to be provided is 6 monthly follow-up consultations for patients with
established locally advanced prostate cancer who are stable on treatment. The
consultation will cover a review of the patients PSA test results, symptoms and side
effects of treatment.
Patients in secondary care with locally advanced prostate cancer stable on
treatment will be identified and discharged from acute hospital care via discharge
letter to their GP. Upon receipt of the discharge letter the patients care is
transferred to the primary care provider who will take formal responsibility and
accountability for the on-going care of the patient.
The primary care provider will ensure:-.
A register is kept of all patients with locally advanced prostate cancer patients stable
on treatment to be managed within primary care;
Each patient on the register is contacted to arrange a review consultation within
primary care with a 6 monthly frequency;
Any patient failing to make an appointment or failing to attend for the review
consultation will be followed up. Should a patient no longer wish to receive followup, this should be documented clearly in the patient’s records and the reason stated;
Each patient on the register to have a named GP who will take responsibility for
managing the care of the patient;
The agreed protocols for management of patients with locally advanced prostate
cancer stable on treatment will be adhered to for the management of every patient.
It is the provider’s responsibility to ensure that the protocols used reflect the most up
to date version;
Specialist advice will be sought wherever required;
All patients will be informed of the results of any tests.
Population covered
The service will be for patients registered with a Hardwick CCG GP Practice.
Any acceptance and exclusion criteria and thresholds
Patients identified within acute hospital care with locally advanced prostate
cancer, stable on hormone manipulation and appropriate for management within a
primary care setting. The service should not currently be provided to patients with
Hormone Relapsed Prostate Cancer (HRPC) or those patients on an Active
Surveillance regime.
The primary care provider will be responsible for contacting the patients discharged
from acute care to arrange the initial, and all subsequent, appointments for review
Interdependence with other services/providers
Secondary Care
Applicable Service Standards
Applicable national standards (eg NICE)
NICE guidelines CG175 updated January 2014 .
Applicable standards set out in Guidance and/or issued by a competent body
(eg Royal Colleges)
Applicable local standards
Applicable quality requirements and CQUIN goals
Applicable Quality Requirements (See Schedule 4 Parts [A-D])
Applicable CQUIN goals (See Schedule 4 Part [E])
Detailed in Over All BOS Specification.
Location of Provider Premises
General Practice
Individual Service User Placement
Not Applicable