Download Cancer Care Reviews

The Cancer Care Review
Name Dr Anthony Cunliffe
Date September 17th 2014
The Cancer Care Review
QOF requirement up to 6 months from GP being informed
of diagnosis
Lack of clarity about what a CCR should entail therefore
patient experience, if any, is very variable
GPs themselves report difficulties doing the CCR compared
to reviewing other LTC
GPs expressed concerns about the emotional content and
about finding it difficult due to patients varying
acceptance of their diagnosis
Problems with current CCR?
The current QOF CCR is done within 6 months of diagnosis
Many GPs express concern that the patient is undergoing
active treatment and often has many hospital
appointments so they feel they have little to add
Often done opportunistically in a 10 minute consultation so
concern that can be seen as a ‘box-ticking’ process
Often no structure so important things get missed
Why do a CCR in Primary Care?
Receiving a cancer diagnosis can be very traumatic.
Having the support of a Dr/Nurse you know well can be
important
GPs/Practice Nurses often know things about the patient
that the specialists won’t - family, work, psychological
history etc
Important for the GP/Practice Nurse to have a clear
knowledge of the patients diagnosis and how they are
managing
Some patients when finished Primary treatment can feel
lost so having had that link with the GP/Practice Nurse
regarding their cancer can act as a reminder that they
are there to manage cancer related problems too
Is the current CCR enough?
Already talked about the many long term consequences of
cancer and its treatment
What is currently offered to patients LWBC?
Often just opportunistic reviews or unsatisfactory
consultations when symptoms/problems not being
managed optimally
How does this compare to what we offer patients with other
LTCs???
Should cancer patients get an annual review following
diagnosis??
Annual Reviews for LTCs
What things are discussed??
• General Health
• Lifestyle discussion and advice.
• Problems with treatment
• Specific symptom review
• Signposting to local services
Do we think many of these questions would be applicable
to patients LWBC??
The Macmillan CCR Template.
The Macmillan CCR Template
Evaluation
79% of GPs found it useful
88% said it useful to also have Macmillan information at
hand to use
Issues discussed – diagnosis, treatment, medication,
information, financial issues BUT variable!!
Patients happy with it also – 75% described the experience
as very satisfactory
Often patients didn’t know they were actually having a CCR
Often not a set aside appt – opportunistic. Is this OK?
A Holistic CCR – useful addition to
community cancer care?
As for other LTCs – aim to address all issues in one
consultation so that patients are better managed, happy
with their care and have their needs met
Done by GP? PN?
When? - At end of acute treatment? Annually?
Patients encouraged to consider issues in advance of
review so things not missed
Crib sheet and useful links/information provided to be used
in the review
Reduce GP appointments/emergency presentations?
Is this what patients want/need?
Thank you
11