The NCDA combines primary and secondary care patient data to better understand pathways to cancer diagnosis. Findings for the region have now been released and show 555 practices, 66 PCNs and 31/32 CCGs participated in 2019. Completion level in London for 2018 data was 42% compared to 13% nationally.
14,995 cancers in 2018 out of a total of 33,644 (45%) were audited. London now has a dataset that is giving us insights to help us achieve the national Faster Diagnosis target and the target to diagnose 75% of patients at an early stage. Highlight findings from the London audit include:
- More cancer patients were younger, aged 50 to 64 years, in London compared to 65 to 74 years in England.
- White ethnicity was 68% in London compared to 86% in England.
- The most common place where patients first presented was the GP surgery (for 64% of all patients), however only 45% lung cancers first presented in primary care compared to 80% of prostate cancers.
- Safety netting is gaining ground and was recorded for 39% of patients. GPs felt safety netting had made a positive contribution to the diagnosis in over a quarter of cases.
- 55% of patients were referred via 2WW and 11% were referred as an emergency. Over a third of emergency patients self-referred with no prior relevant GP consultations.
- Patients in London are referred quicker to a first appointment for cancer symptoms, but it takes longer for patients to receive a diagnostic test.
- 74% of patients had fewer than 3 consultations before a referral that led to a cancer diagnosis, however 14% of both lung and upper GI patients and 13% of colorectal patients had more than 3 consultations.
- 69% of patients had at least one co-morbidity prior to diagnosis
In line with the PCN DES, we would encourage practices to establish communities of practice and share their learning with others, ascertain where good practice exists, and identify avoidable delays and what needs to change.
Once again thank you to those who participated. For any practices still awaiting payment for their audit activity please contact: England.TCSTLondon@nhs.net
