Use rigorous safety netting when making a suspected cancer referral, requesting direct access diagnostics or to re-appraise the clinical picture to reassess a patient’s risk of cancer.
Suspected cancer referrals
The Pan-London Suspected Cancer Referral forms (2016), referral criteria and supporting clinical information have been developed by the Transforming Cancer Services Team, Healthy London Partnership, London Cancer and London Cancer Alliance.
The Pan-London position includes the following:
NICE guideline NG12, Suspected cancer: recognition and referral (2015) using primary care data
Retention of some symptom criteria from NICE guidelines: CG27 Referral guideline for suspected cancer (2005); CSG9 Improving outcomes for people with sarcoma (2006); CG122 Ovarian cancer: recognition and initial management (2011)
The positive predictive value (PPV) of symptom criteria for referral has been reduced from 5-10% to 3%
Lowered age thresholds in some tumour groups based on London demographics and cancer incidence
Supports the initiative in primary care for direct and rapid access diagnostics
Proactive safety netting of a patient's symptoms, diagnostics and suspected cancer referrals
Oversight by the Pan-London two-week wait operational group working closely with London CCG cancer leads, Macmillan GP advisors, tumour group pathway directors, dentists and patient groups.
New Pan-London Suspected Cancer Referral Forms (2016)
The new electronic referral forms are available for EmisWeb, SystmOne (Integrated, Non-integrated), Vision and DXS.
GPs in all CCGs in the London area are advised to use these forms when referring patients with a suspected cancer as they contain the updated guidelines from NICE published in 2015 (NG12) as well as additional tumour specific referral criteria and deviations which have been agreed for the London area.
While guidelines assist the practice of healthcare professionals, they do not replace their knowledge, skills or clinical judgement. NG12 also supports clinicians to refer patients appropriately where cancer is suspected even if the patient does not meet NG12/Pan-London referral criteria.
Referrers should include as much clinical and patient sensitive information as possible to enable swift triage and processing.
Access the Pan-London Suspected Cancer Referral Forms (2016)
Use the links below to access the referral forms and supporting information
London area CCGs, Cancer/GP leads and Macmillan GPs have worked alongside hospital specialists, pathway groups and patient representatives to develop the new forms. Our aim is to improve the pathways and referral procedures for patients with suspected cancer and hope these forms will be seen as a significant step forward.
Once the new forms have been installed please deactivate and remove all old versions. Queries regarding upload or technical support should be raised with the CCG IT or cancer lead who will liaise and feedback to the Transforming Cancer Services Team where necessary.
The new forms have been sent to the London contracts team at DXS. They were made available on the 9th May 2016 for London CCGs using DXS.
Hospital Cancer Office Contact Information
Located at the top of each form is a weblink providing up-to-date London hospital contact information including email addresses and telephone numbers. We recommend suspected cancer referrals should be emailed or sent by e-referral (formerly known as Choose and Book).
The electronic referrals method significantly improves reliability and patient safety which is consistent with good practice. CCGs using an agreed Referral Facilitation Service (RFS) should continue to do so.
The weblink is updated regularly; in order to ensure it remains up-to-date please notify the Transforming Cancer Services Team immediately of any changes to hospital two-week wait / suspected cancer office contact details.
Queries and support
For educational or Pan-London suspected cancer referral queries please contact Dr. Ishani Patel, Transforming Cancer Services Team, GP Advisor
For direct access diagnostics queries please contact Dr. Martin Shelly, Transforming Cancer Services Team, Diagnostics Lead
For general queries please contact Ms. Zara Gross, Transforming Cancer Services Team, Cancer Strategy Implementation Support
Email contact: SECSU.email@example.com