DETECT CANCER EARLY NewsleTTer. ISSUe 8 Scottish Referral Guidelines for Suspected Cancer. The Scottish Referral Guidelines for Suspected Cancer have been refreshed and were launched on 4 September. They were produced by a Detect Cancer Early initiative and supported by Healthcare Improvement Scotland. The guidelines can be found here. Ongoing support and collaboration with multi-disciplinary colleagues during this process was tremendous. Each tumour specific guideline group had representation from a variety of healthcare professionals including: GPs, members from the cancer coalition, pharmacists, clinical nurse specialists, secondary/tertiary care clinicians and lay representatives, who were invaluable. There was also an overarching steering group which signed off amendments to the guidelines following a comprehensive peer review process and the guideline dissemination group ensured that the guidelines were cascaded to all relevant parties by the most appropriate mechanism. The guidelines were endorsed by the Scottish Cancer Taskforce. The guidelines, although aimed specifically at GPs, in order to help refer appropriate patients with an urgent suspicion of cancer to secondary/tertiary care, are also aimed at pharmacists. They regularly see patients with recurring symptoms which may be suggestive of an underlying pathology and by referring to the guidelines can signpost patients to their GPs for review. In order to ensure that as many pharmacists in NHS Scotland are familiar with the referral guidelines, Macmillan Cancer Support has funded the design and printing of a Quick Reference Guide to ensure that all community pharmacies, GPs and GP Trainees have copies. These are also being sent to out-of-hours and prison services. Macmillan Cancer Support has also supported PDFs of the guidelines which will be available to every GP practice. It is recommended that the cancer specific proformas on SCI Gateway are updated to incorporate any changes resultant from the publication of these guidelines by December 2014, this has been endorsed by the SCT. It has also been requested, via communications managers in each Health Board, that the updated guidelines sit on local intranet sites. In order to ensure that the public are sighted on the guidelines, there are hyperlinks from Healthcare Improvement Scotland to the Cancer Zone on NHS Inform and Get Checked Early. The cancer coalition has been instrumental in highlighting the guidelines via respective charities.
Finally I would like to thank everyone who has contributed to this process and been involved in updating the guidelines, including secondary/tertiary care clinicians, GPs, pharmacists, nurse specialists, the cancer coalition and lay representatives. From Left: Dr Peter Hutchison, Vice Chair, Referral Guidelines Groups; Hilda Emengo, Health Services Researcher, Healthcare Improvement Scotland; Sara Twaddle, Director of Evidence, Healthcare Improvement Scotland; Jacquie Dougall, Programme Manager, Cancer Support Team, and Dr Bob Grant, Chair Referral Guidelines Groups. Dr Bob Grant Chair Scottish Referral Guidelines Group South East Scotland. Breast screening service The South East Scotland Breast Screening service has been working on a programme of improvement during 2013/14 targeting areas of lowest uptake in NHS Lothian. A summary of the projects are outlined below: Pilot study with Lothian HB looking at increasing awareness of breast and bowel screening programmes which has been nominated for a Scottish Health Award 2014. Involvement in pilot study looking at two practices to identify medical reasons for non-attendance in the programmes. This paper has been submitted to a medical journal for publication. Client survey looking at reasons for non-attendance in the Scottish Breast Screening Programme further details available. Initiative to improve uptake in Polish speaking clients involving letters in Polish and a special clinic with an interpreter. Further work on this is still being carried out. Initiative to improve uptake in Craigmillar area of Edinburgh a walk-in service was offered to ladies from this practice who were previous non attenders. Production of video with DCE and Elaine C Smith Behind the Breast Screen(ing) available to view here and on YouTube. Assisting Breakthrough Breast Cancer charity in their survey of breast awareness leaflets. Participation in breast awareness roadshows with DCE. All of these were being carried out during the Digital Mammography Implementation within the South East Breast Screening Service. Further details can be provided on request. Mary Tait Specialist Radiographer / Health Promotion Facilitator NHS Lothian
NHS FIFE. NHS Fife asks residents What do you know about detecting cancer early? Health Promotion Fife commissioned research to find out what level of knowledge residents had about the signs and symptoms of breast, bowel and lung cancer. It also assessed their awareness of the national DCE campaign, their understanding of the benefits of screening and what motivates them to pursue or decline screening opportunities. Amongst other things, the survey has shown that Fifers aged 50 74 have a reasonably good recall of the national campaigns, with the exception of the microscope over the toilet which had only 41% recall. Interestingly, awareness was generally higher amongst those living in more deprived areas. Understanding of what the campaign messages meant was less clear. In particular, for bowel cancer, only 11% explicitly recognised that early signs are difficult to detect, with 31% being unaware that screening is the only accurate method of detection. A quarter of respondents couldn t name any of the signs or symptoms of lung cancer without being prompted. 18% of women said they didn t check their breasts at all citing forgetfulness as the reason. Locally, the results are invaluable as we are able to target communities more specifically with the support and information they need. For example, we can target young working males, as they are less likely to participate in the screening process. Quotes from participants on raising awareness: People are frightened so showing them positive results helps. The more you see the advert the better, more awareness. At any routine visit to the GP, the message should be given. So it s good to use a GP in the ads. When they send out kits they should be more red alert - you should rather than please. Fiona Lockett Health Promotion Officer - Cancer
WEST OF SCOTLAND. Breast screening service As part of the Detect Cancer Early campaign, the West of Scotland Breast Screening Service has been asked to take part in a targeted pilot to promote the uptake of breast screening. At present, all women invited from GP practices in the Greater Glasgow & Clyde (GG&C) area are sent a teaser letter two weeks prior to their appointment letter being sent. The new pilot continues to send this letter as well as trialling text and phone reminders of appointments. 11 low uptake practices for GG&C and one low uptake practice from Lanarkshire were asked to take part in the pilot of which one GG&C practice declined and a response is awaited from another. The pilot commenced in August and will finish in November 2014. It was agreed that all first time women being invited to the service were to be sent a text reminder a few days prior to their appointment (if mobile number available) and women who previously DNA a screening appointment would be given a telephone reminder a few days prior to their appointment. The pilot is still in its early days as the service is only on practice 3 of 10 or 11. Attendance figures are continuing to be collected for the first two practices to ascertain whether the pilot has made an impact on uptake. Anecdotally, a number of women have mentioned to mammographers at the time of their screening (in a positive manner) that they received a text reminder. In addition, when conducting phone reminders, a handful of women who were honest and advised they were planning on not attending prior to the phone call, did in fact attend their screening appointment. The telephone reminder has allowed changes to be made to appointments which are unsuitable. I would like to thank all staff who are involved in this ongoing pilot and I look forward to gathering and sharing the results in due course. Donna Wilson Administration Manager
SOCIAL MARKETING UPDATE. Breast screening campaign. We ve been busy touring our breast screening roadshow around local communities. Working closely with the Scottish Breast Screening Programme, we re targeting the South East and West where uptake is poorest and activity most needed. In June alone, we staged 15 different locations, from Craigmillar to Castlemilk. The interactive stand featuring examples of the campaign creative and Elaine C Smith footage, has been well received at shopping centres and local supermarkets. The message is clearly getting through, as there have been over 5,000 hits to www.getcheckedearly.org, the campaign website, since the screening activity commenced. Supporting PR has focused on regional media and we ve been providing fresh content for our social media channels and generally spreading the #detectcancerearly message. Journalists are always on the look-out for real human interest stories, so if you have any casestudies (or if you need more campaign assets) please do contact the PR team. Email: DCE@consolidatedpr.com Lung cancer will be taking a symptom specific approach this November, so watch this space CANCER TEAM CONTACT DETAILS cancerdeliveryteam@scotland.gsi.gov.uk CANCER. DON T GET SCARED, GET CHECKED.