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RCGP - NCAT Cancer Diagnosis Audit The report generated below should be of interest to your own practice. The information will also be of use to the

National Cancer Action Team PCT's Primary Care Cancer Lead when considering potential improvements to local cancer services.

(For the period dd/mm/yy - dd/mm/yy)

Total No. Not referred by No. where avoidable

Practice Completed by Emergency 2 week Routine

patients Practice delay identified

Name

0 0 0 0 0 0

If you have any queries on the use of this form, please contact…..

If known, enter Date patient How many times did Did the GP Would rapid access to If yes, which Date Which Date first seen Were there Were there If patient No. days from first Time from referral Total time from

Patient ID Where is this Does this patient Please enter What was Where did the What was the If yes, please list Which Trust Time from first

Gende Is this patient date patient reported symptom patient attend organise any investigations have investigation Referral speciality or investigated any delays any avoidable If Yes or unsure, please deceased, symptoms / signs to date first seen first symptom or

(for Type of Cancer Total

Age Ethnicity patient's country of have any problems Diagnosis further details of the stage at first noted patient first main presenting investigations was the Type of referral was the patient informing the delays to this enter Date of attendance to sign to date first

practice r housebound? or sign to Primary surgery before they investigations altered your management would have been Sent by specialist comment to Primary Care by specialist

use only)

birth? communicating? the diagnosis diagnosis? symptoms or present? symptom? ordered referral referred to? practice of the patient's Death referral (days) seen by

Care (dd/mm/yy) were referred? before referring? of this case? most useful? (dd/mm/yy) (dd/mm/yy) attendance (days)

signs of cancer sent to? diagnosis? journey? (dd/mm/yy) specialist (days)

The information to the 0 0 0 0 Bladder 0

right of this column will 0 0 0 0 Brain 0

be calculated 0 0 0 0 Breast 0

automatically from any 0 0 0 0 Cervical 0

0 0 0 0 Colorectal 0

dates entered for the

0 0 0 0 Endometrial 0

patient.

0 0 0 0 Gallbladder 0

0 0 0 0 Laryngeal 0

0 0 0 0 Leukaemia 0

0 0 0 0 Liver 0

THIS FUNCTION WILL 0 0 0 0 Lung 0

ONLY WORK IF 0 0 0 0 Lymphoma 0

DATES ARE ENTERED 0 0 0 0 Melanoma 0

FOR EACH CELL IN 0 0 0 0 Mesothelioma 0

0 0 0 0 Myeloma 0

THE CORRECT

0 0 0 0 Oesophageal 0

FORMAT (dd/mm/yy)

0 0 0 0 Oropharyngeal 0

Please ensure that you 0 0 0 0 Ovarian 0

have used forward 0 0 0 0 Pancreatic 0

slashes ( / ) and not 0 0 0 0 Prostate 0

dots or dashes 0 0 0 0 Renal 0

0 0 0 0 Sarcoma 0

0 0 0 0 Small Intestine 0

0 0 0 0 Stomach 0

0 0 0 0 Testicular 0

0 0 0 0 Thyroid 0

0 0 0 0 Vulval 0

0 0 0 0 Other 0

0 0 0 0 Unknown Primary 0

0 0 0 0 No Information 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

If known, enter Date patient How many times did Did the GP Would rapid access to If yes, which Date Which Date first seen Were there Were there If patient No. days from first Time from referral Total time from

Patient ID Where is this Does this patient Please enter What was Where did the What was the If yes, please list Which Trust Time from first

Gende Is this patient date patient reported symptom patient attend organise any investigations have investigation Referral speciality or investigated any delays any avoidable If Yes or unsure, please deceased, symptoms / signs to date first seen first symptom or

(for Type of Cancer Total

Age Ethnicity patient's country of have any problems Diagnosis further details of the stage at first noted patient first main presenting investigations was the Type of referral was the patient informing the delays to this enter Date of attendance to sign to date first

practice r housebound? or sign to Primary surgery before they investigations altered your management would have been Sent by specialist comment to Primary Care by specialist

use only)

birth? communicating? the diagnosis diagnosis? symptoms or present? symptom? ordered referral referred to? practice of the patient's Death referral (days) seen by

Care (dd/mm/yy) were referred? before referring? of this case? most useful? (dd/mm/yy) (dd/mm/yy) attendance (days)

signs of cancer sent to? diagnosis? journey? (dd/mm/yy) specialist (days)

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

Do not enter any data below this line, it will not be analysed or included in the automatically generated report

CANCER PATHWAY NOTES

Template Heading What is wanted



Some way for your practice to identify the patient. Please do not use

Patient ID patient name, DOB or any other identifiable data. Consider using

computer number



Age Age in years rounded to nearest year

Gender Male or Female

Ethnicity Ethnicity of patient

Country of origin Patient's country of origin

Problems communicating Any communication problems the patient has

Housebound Is the patient housebound

Enter the diagnosis of the primary cancer Please note that the audit

should only include confirmed malignancies and EXCLUDES non-

Diagnosis

melanotic carcinomas of the skin. Also EXCLUDE CIN, for example

of the cervix, or other carcinoma in situ.

For all date entries please enter date as dd/mm/yy. This will allow a

hidden program to calculate the number of days between different

Date patient noted first symptoms

dates. If the notes only refer to the month (i.e. diarrhoea since May

or signs of cancer

2007), put '15th' as the day of the month (i.e. 15/05/07) If the date is

not known, please enter 'NK'

First notification to any health care professional working within the

Date patient reported symptom or

Primary Health Care Team about a symptom or sign which was

sign to Primary Care

probably due to the cancer

Date that a Primary Health Care professional decided to refer the

Date of Decision to Refer patient to secondary care for further investigation or management of

the symptoms or signs suggestive of cancer

Date that the referral letter was sent from Primary Care. If this is not

Date Referral Sent available, please use the date that the referral letter or proforma was

completed.

The urgency with which a patient was referred for further

Type of referral

investigation or management

Date the patient first had contact with secondary care following the

Date first seen by specialist

referral, whether for an investigation or an out patient appointment

Do you think that there were avoidable delays in the practice being

Delays in informing practice

infromed?

Were there avoidable delays to this Reflect on the referral process and consider what things may have

patient's journey improved the diagnostic journey for the patient, and how things may

If yes, please comment have been improved

WAY NOTES

Why this is wanted



To allow the GP practice to identify and differentiate

between different patients when completing the template







To help determine any relationship between

age/gender/ethnicity/language/communication

problems/access and the likelihood of urgent referral or

diagnosis of cancer







This will allow comparison about the referral process for

different types of cancer





The cancer journey starts when the patient first notices a

symptom or sign that is suggestive of cancer. There may

be long delays before the patient then presents to Primary

Care. Noting how long the patient waited before presenting

may provide useful information about barriers to attending

for health care. It may also help inform which cancers

need Health Promotion campaigns to encourage earlier

attendance.

To identify if there is any delay in actioning referral in

certain cancers.



To identify if delays in practice systems significantly affect

overall waits for treatment from first presentation.

To allow GPs to review the urgency with which they

referred their patient





This information (if available) will help give information

about any delays around diagnosis or communication





Powerful learning tool and opportunity to make suggestions

about how the referral process could be improved.



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