Last reviewed: 8 May 2024
Last reviewed: 8 May 2024
PCNs are required to work with Cancer Alliances to increase early diagnosis rates and improve referral practice. PCNs and Alliances should develop a clear set of actions and milestones to improve referral practice for colorectal cancer, lung cancer as well as one other cancer type to be determined locally, based on the burden of late-stage diagnosis and opportunities for timely and effective referral to support early diagnosis.
A PCN should also work with Alliances and their GP Practices to:
Ensure local referral practice reflects NICE NG12 Guidelines.
Undertake referral audits for people who have received a diagnosis of cancer.
Use Office for Health Improvement and Disparities (OHID) Fingertips to inform improvement actions.
Assess different stages in the pathway for improvement – this could be between first presentation and when an urgent suspected cancer referral is made, and the number appointments between these.
PCNs should also look to support and streamline diagnosis and referral through:
Direct access tests where urgent investigation is required.
Use Faecal Immunochemical Testing (FIT) with patients presenting with lower GI symptoms.
Promote the use of Non-Specific Symptoms (NSS) pathways for patients with non-specific symptoms.
The use of teledermatology to support faster skin cancer referrals.
Download our NICE NG12 interactive symptom guide or NICE NG12 body poster. Both resources summarise NICE suspected cancer guidelines (NG12) by symptom type to support GPs with navigating and applying the guidelines in practice.
Watch Dr Anant Sachdev, Cancer Research UK GP, highlight the importance of routinely using suspected cancer referral guidelines.
If you're assessing patients via phone or video, visit our remote consultations webpage. It aims to help GPs to get the most out of remote consultations and support the timely recognition of suspected cancer signs and symptoms.
Read our FIT Symptomatic webpage to improve your knowledge of the use of symptomatic FIT in primary care. You’ll find resources to encourage uptake and guidance on how to effectively safety net patients without a completed test or with a negative result.
Download our FIT screening v symptomatic pathway graphic (England) for an overview of how FIT is used in bowel cancer screening and the investigation of symptomatic patients.
Download and share our ‘How to complete a symptomatic FIT’ guide with patients.
Read our skin cancer insight guide to improve your knowledge of typical features and referral guidelines for suspected skin cancer.
Read NHS England’s dermatology digital playbook for support on how to use digital tools that support the delivery of patient pathways.
Visit our non-specific symptoms webpages for guidance on how to refer patients with non-specific symptoms and top tips for effectively managing them.
Neil Smith, Cancer Research UK GP, highlights the key considerations when managing people who present with non-specific symptoms.
Read our guide to managing non-specific signs and symptoms of suspected cancer on
Doctors.net (free, login required).
Safety netting is a diagnostic management strategy that aims to ensure patients are monitored throughout the diagnostic process until their symptoms or signs are explained and results have been acted upon or their symptoms are resolved.
See our summary of key safety netting actions(PDF) to support primary care health professionals in practice.
You can use our safety netting flow chart(PDF) which provides an overview of the safety netting pathway.
Learn more about safety netting and our resources on our safety netting hub.
Direct patients to our ‘Your urgent suspected cancer referral explained’ webpage or download our free wallet card sized leaflet to help patients who’ve been urgently referred with suspected cancer to prepare for their appointments and tests.
PCNs are required to work with partners to improve screening uptake, inclusive of breast, bowel and cervical cancer. This includes using data to understand variance in screening programme uptake, auditing non-responders to the cancer screening programme and ensuring screening history is checked at every appointment.
Our reducing inequalities in cancer screening guide(PDF) provides tips and information to help address breast, bowel and cervical screening inequalities.
Visit our health professional screening webpages for an overview of bowel, breast and cervical screening programmes and guidance on encouraging informed participation.
Read our Bowel Cancer Screening Good Practice Guide (2023) And Cervical Screening Good Practice Guide (2024) for primary care. The guides provide practical tips, information and signposting to resources for to support informed participation.
Use our cancer screening at a glance resource for a quick reference of the eligibility criteria for the screening programmes.
Refresh your knowledge of the differences between the symptomatic and asymptomatic (screening) uses of FIT. This guide may also help you to explain the roles of the test to your patients, and the importance of completing a screening FIT even if they recently completed a symptomatic test. Practices may find further information on our FIT Symptomatic webpage useful.
To support patients: Cancer screening webpages; How to do the bowel cancer screening test patient video and 'Tips for collecting your poo and completing the bowel screening test'.
A PCN must seek to improve health outcomes for its population using a data-driven approach and population health management techniques in line with guidance and the CORE20PLUS5 approach. PCNs should work in partnership within local communities to deliver effective outreach and target care to address health inequalities that are amendable to primary care intervention.
Our reducing inequalities in cancer screening guide(PDF) provides tips and information to help address breast, bowel and cervical screening inequalities.
Read our screening information for trans or non-binary people.
Read our Cancer in the UK 2025: Socioeconomic deprivation report(PDF) for statistics about health inequalities in the UK.
Explore insights from our Cancer Awareness Measure ‘Plus’ (CAM+). This is a survey that regularly collects information about UK public’s attitudes and behaviours across key early diagnosis areas, including barriers to accessing primary care services.
Read our articles series on health inequalities and blog post on Health inequalities: breaking down barriers to cancer screening.
Support your patients to stop smoking by referring them to our ‘How do I stop smoking’
page.
Find out more about smoking cessation interventions on The National Centre for Smoking Cessation and Training website.
Please note these videos were produced in 2021/22 and the content is still relevant for 2025/26, except for references to the Covid Hub and Facilitator Programme, which no longer exist. You can find out more information and support on our Health Professional website pages.
Macmillan GP Cancer Lead, Dr Anthony Cunliffe, provides his top tips for tackling the PCN DES cancer early diagnosis 2021-22.
CRUK GP Leads, Dr Jo Thomson and Dr Pawan Randev, discuss how Primary Care Networks can get started with work on cancer early diagnosis for the PCN DES 2021-22, and make suggestions for quality improvement activities to consider.
CRUK GP, Dr Neil Smith, shares his ideas on how Primary Care Networks can plan and build on cancer improvement activity to meet the requirements of the PCN DES 2021-22.
CRUK GP, Dr Ameesh Patel, talks about cancer safety netting requirements in the PCN DES 2021-22, including the new cancer safety netting SNOMED code, and what metrics PCNs could look at to inform activities.
Macmillan GPs, Dr Anthony Cunliffe and Dr Tania Anastasiadis, discuss digital and tech solutions that can support Primary Care Networks to meet requirements of the PCN DES on cancer early diagnosis 2021-22.
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