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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