NICE suspected cancer referral guidelines
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Updated National Institute of Health and Care Excellence (NICE) referral guidelines for suspected cancer were published on 23rd June 2015, replacing the 2005 version.
The NICE guidelines make recommendations on how to manage children, young people and adults with potential cancer symptoms that present to primary care. They set out;
The updated NICE guidelines include a number of changes aiming to give GPs more flexibility to refer patients in order to help diagnose cancers earlier;
NICE estimate that the guideline changes will lead to a significant increase in referrals, which will have cost implications. However, it’s also likely that there will be wider benefits to patients and the NHS, such as reduced emergency presentations and lower treatment costs for patients diagnosed earlier.
There is already considerable financial pressure on NHS services and with the number of people diagnosed with cancer increasing – further investment is essential in order to support this much needed shift in investigative testing.
NICE have produced a number of resources to help local teams assess the impact of the guidelines on services.
NICE outline a number of benefits that the changes to the referral guidelines, in particular lower referral thresholds, may bring to both patients and NHS services;
Dr Richard Roope, a practising GP and clinical lead for cancer at Cancer Research UK and the Royal College of General Practice, shared his thoughts on the potential benefits of the new guidelines.
NICE’s costing team worked with the Guideline Development Group and other professionals to estimate which recommendations in the updated guidelines would have the most significant impact on referrals and tests for suspected cancer.
The tumour groups for which a significant resource impact is estimated are:
Suspected cancer pathway referrals for these tumour groups equate to 30% of suspected cancer pathway referrals for 2013/14. For other tumour groups NICE do not anticipate significant changes.
More information on the impacts of specific guidelines are detailed in a costing statement from NICE along with a wider assessment for bowel cancer highlighting the varying impacts of the guidelines on different NHS service.
NICE have produced a number of resources to help local teams understand and evaluate the impacts and costs of implementing the guidance.
Cancer Research UK brought together a team of health professionals from across the cancer pathway to reflect on the NICE suspected cancer recognition and referral guidelines and share their tips for local implementation.
Our facilitators are working with local teams in many parts of the country to support implementation of the guidelines.
Our facilitators work in partnership with NHS Commissioners, GP Cancer Leads, Public Health and other local bodies to provide support to GP practices.
We have produced an interactive desk easel for GPs, in conjunction with the Royal College of General Practitioners (RCGP),which summarises the NG12 guidelines. Designed as a pdf document, GPs can access the summary from their computer and click through to the recommendations for each symptom group. Recommendations for adults, children and young people are covered, as well as primary care investigations. There’s also some additional advice on diagnostic tests and safety netting.
Download the interactive desk easel
We will be distributing a limited number of hard copies to GPs via our facilitators – find out whether you have facilitators in your area.
If you have any feedback or comments about the easel please get in touch at earlydiagnosis@cancer.org.uk or fill in our online survey.
We have developed three symptom-led summaries of the guidance with the help of Dr Richard Roope and the Royal College of General Practitioners (RCGP).
Since publication in November 2015 we have updated the summaries to produce new versions. Please take all copies of the November 2015 posters out of circulation and use the March 2016 posters (marked version 2) from now on.
Download the posters:
Or order physical copies of these poster resources, for free, from the CRUK publications website.
We are keen to hear your views on these resources. If you have any feedback, you can get in touch at earlydiagnosis@cancer.org.uk.
NICE have provided their guidance organised by cancer site and by symptom and findings of primary care investigations. They have also provided a pathway tool which is searchable by cancer site or symptom.
The BMJ have published two summaries of the guidance from W Hamilton, et al;
Macmillan Cancer Support have produced an update to their “Rapid Referral Toolkit” summarising the recommendations in the guidelines.
These short videos explain the key information from NICE referral guidelines for 5 cancer types to help GPs put them into practice.
These videos are from NHS Wessex Clinical Networks in partnership with CRUK. They were created by CRUK strategic GP Paul Barker and produced by Jon Nichols.
Key signs and symptoms of cancer for the public (CRUK)
Information for the public on the symptom guidelines (NICE)
Safety netting recommendations (NICE)
Safety Netting Recommendations (CRUK)
Learning and development tools for GPs (CRUK)
Educational resources from the North West Coast SCNs (NHS)
Bowel screening information for Health Professionals
Oral cancer toolkit (CRUK and BDA)
NICE press release on the updated guidelines
CRUK blog: Dr Richard Roope “New NICE GP guidelines have huge ambition and potential”
CRUK Blog “Cancer waiting time targets are being missed across the UK”
RCGP response to the new guidance
NICE suspected cancer referral guidelines
Research & References of NICE suspected cancer referral guidelines|A&C Accounting And Tax Services
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