Primary care plays a vital role in the early diagnosis of cancer. If a cancer is diagnosed at an early stage, there is an increased range of treatment options, improved long-term survival and improved quality of life for patients.

The ambitions of the NHS Long Term Plan are by 2028, the proportion of cancers diagnosed at stages 1 and 2 will rise from around half now to three-quarters of cancer patients. In order to achieve that, the Primary Care Network Directed Enhanced Service (PCN DES) for Supporting Early Cancer Diagnosis sets out five core contracted requirements for primary care teams for 2022-23. They are:

  1. Review referral practice for suspected and recurrent cancers
  2. Improve uptake in cervical and bowel screening
  3. 3a Adopt and embed FIT testing for suspected colorectal cancers, and 3b Adopt and embed teledermatology to support skin cancer referrals
  4. Increase proactive and opportunistic assessments for prostate cancer
  5. Review use of non-specific symptoms pathway

To support PCN teams to meet those requirements, we have created this PCN Des toolkit of resources. It includes:

  • `How to' guides on each of the contracted requirements 
  • The Cancer Indicators dashboard
  • A `how to' guide for using Ardens in delivering the PCN Des requirements
  • A Surrey and Sussex Cancer Alliance webinar with practical top tips and essential resources

The Cancer Indicators dashboard has been designed to support primary care networks within the Surrey and Sussex Cancer Alliance area by providing them with a tool that allows interrogation of cancer data at various levels, prompt work plans to improve screening and reduce variation within their region.

The dashboard includes Screening Indicators and Cancer Profile indicators, and charts are laid out by PCN and GP practice.

You can download the dashboard here: SSCA Cancer Indicators dashboard. It will download into the bottom left-hand corner of your screen. Open the file and click `enable edit’. (if your computer does not have the latest Excel programme you may see the words ‘Couldn’t Open the Workbook as it exceeds 25MB file size limit’. If that happens, continue to click the blue `download file' tab at the top of your screen and you will be able to access the dashboard) 

This video gives step-by-step tuition to help users navigate their way around the dashboard: How to navigate the SSCA Cancer Indicators dashboard.

In July 2022, Surrey and Sussex Cancer Alliance hosted a webinar with Ardens on how to use its resources to support PCNs to meet the PCN DES requirements.

You can find the complete recording of the webinar here: `How to' guide for using Ardens in delivering the PCN Des requirements – EMIS’ 

We have also created seven short videos of each of the key instructions from the webinar. These are step-by-step guides detailing the Ardens for EMIS resources and how to access them. Click on the links below to access the videos.

  1. Locating the Ardens for EMIS Network DES searches: a step by step guide to the Network DES searches which will help practices to identify the work they have done so far to meet the PCN DES requirements and what needs to be done.
  2. Identifying early signs of cancer – Ardens clinical safety alerts: the clinical safety alerts will flag up potential safety issues for patients. These alerts will pop up in real time for all staff in practice as they enter information about a patient. The safety alerts follow the latest NICE cancer guidance.
  3. Identifying early signs of cancer – possible cancer searches using Ardens for EMIS: these searches will help you identify potential patients who may have cancer by analysing information already recorded for that patient. This video encourages GP practices to run these searches regularly.
  4. Supporting early cancer diagnosis – using the Ardens for EMIS NG12 Cancer Analyser tool: how to use the Ardens for EMIS NG12 Cancer Analyser during a consultation to determine if a patient’s symptoms meet the criteria for urgent cancer referral and to inform the next steps for that patient.
  5. Supporting early cancer diagnosis – using the Ardens for EMIS Fast Track Safety Netting resources - these resources will support cancer safety netting work as part of the PCN DES. Keep track of patients who have been sent on an urgent cancer pathway and of any urgent diagnostics for patients. The resources will also help to monitor high risk patients.
  6. Supporting early cancer diagnosis – using the Ardens for EMIS cancer referral forms: This step-by-step guide explains how to access and use the urgent cancer referral forms which have been embedded within the EMIS system. These forms also include a clinical diagrams template to record the location of lumps and bumps on a patient’s body.
  7. Supporting searches – Network DES, and Ardens cancer and case finder searches: a summary of all the searches available through the Ardens for EMIS including the recall system for screening, safety netting searches and a tool to assist matching FIT test codes coming in from pathology laboratories with FIT code requirements for the PCN DES.  There is also a prostate cancer risk search to identify patients with high risk factors for prostate cancer.

In August 2022, Surrey and Sussex Cancer Alliance hosted a webinar on how to use Ardens for SystemOne resources to support PCNs to meet the PCN DES requirements.

We have created four short videos of each of the key instructions from the webinar. These are step-by-step guides detailing the Ardens for SystmOne resources and how to access them. Click on the links below to access the videos:

  1. Using Ardens SystmOne to help deliver the early diagnosis of cancer PCN DES requirements - an introduction ot Ardens SystmOne and explanation of why it is important to diagnose cancer early.
  2. Supporting early cancer diagnosis – using Ardens SystmOne screening templates -  how to use the screening templates and the support tools available including sending letters and text messages to patients and recording FIT tests.
  3. Supporting early cancer diagnosis – using the Ardens SystmOne GP consultation templates -  how to use the GP consultation templates and the supporting tools, including the urgent suspected cancer referral criteria, patient information leaflets and the NG12 cancer symptoms and findings Cancer Analyser.
  4. Supporting early cancer diagnosis – using Ardens SystmOne Cancer Care Review templates - for patients that do have cancer, Ardens SystmOne has Cancer Care Review templates to enable health professionals to record diagnoses, add notes, and carry out three month reviews. There are also end of life and palliative care plans.

This webinar, hosted by Surrey and Sussex Cancer Alliance (SSCA) on 28 June 2022, provides an overview of the Primary Care Network Directed Enhanced Services (PCN DES) Early Diagnosis of Cancer with practical top tips and essential resources. Plus:

  • Handy DES checklists for PCNs to record actions/improvements
  • Advice on how to create an improvement plan
  • Tips on how to build a community of practice.
  • Information about safety netting

You can find the presentation slides to the webinar here: SSCA webinar on the PCN DES Early Diagnosis of Cancer 28 June 2022 

Or you can watch the webinar here: YouTube primary care webinar on the PCN DES Early Diagnosis of Cancer 28 June 2022 

Back to For Primary Care

`How to' guides for each of the requirements of the PCN DES for Early Cancer Diagnosis

Overview and how to get started
Improving referrals - including non-specific symptoms
Improving uptake in cervical and bowel screening
FIT testing to support referrals
Click here for more FIT resources
Telederm to support referrals
Increasing assessments for prostate cancer

To help primary care health professionals and administration teams record the actions they have taken to meet the PCN DES requirements, we have created handy checklists.

You can find blank checklists for each of the five requirements here  - PCN DES checklist templates

We have also produced a set of completed example checklists that can be used for reference. Find them here - PCN DES completed checkist examples