TET Phase 2 - Bowel Cancer

In September 2023, we launched Phase 2 of the TET programme, focused on earlier diagnosis of bowel cancer. Cancer Research UK, supported by the Bowelbabe Fund, has funded five NHS health system teams, all collaborating with an academic partner who will support the co-design of the intervention, evaluate the process, outcomes, and impact of implementation, generating the evidence required to transition effective innovations across mainstream practice. Phase 2 will continue through to Summer 2026. 

A key development for phase 2 was to appoint health system delivery teams before we had finalised interventions. This enabled us to build in a co-design stage supported by a single academic partner across all Phase 2 projects.  

Read more about Phase 1

Test Evidence Transition programme overview

Phase 2 has a single academic partner - a collaboration between The University of Oxford and The University of Cambridge - to work across all five projects. The team is led by principal investigators Dr Brian Nicholson, Dr Anna Dowrick and Dr Sharon Tonner of the Nuffield Department of Primary Care Health Science at the University of Oxford, and Dr Juliet Usher-Smith of the Department of Public Health and Primary Care at the University of Cambridge. The team bring expertise in key areas such as primary care and bowel cancer, co-design, implementation science, health economics and mixed methods research.  

In addition to supporting each individual Phase 2 project, the academic partner will analyse data and harness insights across all projects to co-create programme-level outputs. 

For Phase 2, the health system teams, and their wider stakeholders will collaborate with our academic partner and Cancer Research UK to co-design their innovation. The co-design process is intended to ensure:  

• The innovation to be tested is already supported by evidence of effectiveness, and has the best chance of being adopted in the real-world health service delivery contexts, and can be feasibly implemented and evaluated  

• a methodological approach informed by relevant frameworks and best practice (implementation and behavioural science, NHS research and service evaluation).  

• appropriate patient and public involvement.  

• robust research governance and project management. 

 
Each project’s innovation of focus will fall within the following categories: 

• approaches to target and reduce unwarranted variation in the national bowel cancer screening programme uptake and adherence.  ​ 
• improving attendance at screening initiated diagnostic investigation where there is evidence to suggest barriers and inequalities in attending colonoscopy appointments.​ 
• improving screening and surveillance optimisation in higher risk population groups, including the management of genetic conditions, e.g., such as Lynch syndrome. ​ 
• improving risk assessment of symptomatic patients presenting to primary care. ​ 
• innovative primary-secondary care engagement strategies to support communication and continuity.​ 
• other service innovations to support the delivery of optimal symptomatic pathways that can transform clinical practice at a local level.