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Detect Cancer Early Programme Board
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Thursday 26th September 2013
Direct
Scottish Government, Atlantic Quay, Glasgow
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ACTION NOTE
Health
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Present:
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David
Linden (acting Chair)
and
Nicola
Barnstaple
Perfor
Paul Baughan
manc
David Brewster
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


Sara Conroy
Hilary Dobson
Val Doherty
Jacquie Dougall
Neil McLaughlin (videoconference)
Brian Montgomery (videoconference)
Peter King (videoconference)
Gail Lyall
Louise Wilson (videoconference)
Bob Grant & Sara Twaddle (for item 5)
Nigel Revell & Dawn Crosby (for item 4)
David Weddell (IT support)
1. WELCOME AND APOLOGIES
David Linden welcomed everyone to the meeting. There were apologies from Robert
Calderwood, Emma Anderson, Carol Colquhoun, Alan Cook, Emilia Crichton, Brian Murray,
Sinead Power, Scott Sutherland and Ann Watson.
2. MINUTES OF THE PREVIOUS MEETING – 20 May 2013
The minutes of the previous meeting were agreed as accurate.
There was one outstanding action from the previous meeting to explore the reasons for
variation in the data between NHS boards Q1 and Q4 endometrial cancer waiting times.
Action: Peter Gent
3. MATTERS ARISING
3.1 Cancer Access Standards – performance
The programme board noted performance for 2013 Quarter 2 for the 62-day standard was
94.5 per cent, and for the 31-day standard 97.7 per cent. Seven NHS boards failed to meet
the 62-day standard. Performance support continues to be offered to three NHS boards
where sustaining performance above 95% remains challenging.
3.2 Cancer Access Standards – Sarcoma Cancer Audit
It was agreed that Sarcoma would be audited in 2014. ISD are working with the Scottish
Sarcoma MCN network manager to identify sarcoma patients.
3.3 Cancer Access Standards - Data Quality Audit
The last DQA for cancer access was performed in 2010. It has been agreed that a DQA will
be carried out in 2013/14 and will include cervical cancers and screened detected cancers.
3.4 Cancer Access Standards – Subsequent Waiting Times
The Cabinet Secretary has requested a brief on waiting times for patients undergoing
second or subsequent cancer treatments. There is limited data available on this part of the
cancer pathway as data is not routinely captured by health boards. A further update will be
provided to the DCEPB in due course
Action: DCE national team
3.5 Cancer Access Standards – TTG alignment
The cancer waiting times definitions are under review to ensure that it aligns with the
Patients’ Rights Act (TTG). A progress report will be brought back to the DCEPB.
Action DCE national team
4. SCOTTISH PRIMARY CARE REFERRAL GUIDELINES
Bob Grant and Sara Twaddle presented an update on the review of the Scottish Primary
Care Referral Guidelines for Suspected Cancer. The revised guidelines for breast, lung and
lower GI cancers are available on the NHS HIS website the DCEPB were asked for endorse
the revised guidelines which will be formally approved at the Scottish Cancer Taskforce
meeting on 4th October 2013.
The next set of guidelines to be reviewed are Upper GI, Head & Neck, Prostate & Urological
cancers and Malignant Melanoma. All remaining guidelines will be reviewed by April 2014. A
dissemination group has been convened to look at how the revised guidelines will be
presented to clinicians and the general public.
Peter King drew Board members attention to Section 2.2 of the Referral Guidelines and the
potential for an inappropriate burden to be placed on secondary care clinicians in the
assessment of an underlying cause for persistent symptoms. The Board agreed that the
guidance in section 2.2.5 should provide reassurance around this, that timely feedback to
primary care on outcomes of diagnostic tests or patients that DNA was essential allowing the
GP to take further action as necessary and that good clinical practice should be adopted to
ensure that patients with a negative result are followed up appropriately. The responsibility of
referrers in ensuring that patients are fully informed of the reasons for the diagnostic tests in
secondary care should be explicit within the guidelines. It was suggested that a next step
might be to develop practical tips on managing referrals that could be adopted across
primary and secondary care.
Downgrading of referrals was discussed. There have been issues with returning e-referrals
in some boards making downgrading difficult. Bob Grant agreed to discuss with SCI gateway
colleagues at the referral guidelines dissemination group meeting.
Action: Jacquie Dougall
David Linden formally thanked Bob Grant and Sara Twaddle for their work on the referral
guidelines.
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5. TEENAGE CANCER TRUST – education pilot
Dawn Crosby & Nigel Revell presented an update on the Teenage Cancer Trust education
pilot study underway with the University of Stirling. The organisation has now recruited an
additional member of staff to deliver the education programme and 20 schools in Glasgow
are participating in the study which is the largest study of its kind in the UK. Preliminary
results from the initial pre-study questionnaire are being evaluated by the University of
Stirling. Participants will be followed up 2 weeks after receiving the schools intervention and
again at 6 months to look at retention of knowledge and attitudinal shifts to cancer in the
pupils and their parents (via CRUK CAM measure). A further update will be provided to the
DCEPB once results have been fully evaluated.
6. PRIMARY CARE UPDATE
6.1 GP Practice Cancer Profiles
The programme board noted that the GP practice cancer profiles under development by ISD
are at an advanced stage. Profiles will contain individual GP practice information on cancer
incidence, demographics, mortality, age and screening uptake. The programme board
discussed publication of the profiles and whether practice codes should be anonymised on
publication.
The practice profiles have been discussed at the Scottish Primary Care Cancer Group
(SPCCG) and there was agreement that the profiles should be publically available with
practices being identified via practice codes.
It was agreed that profiles should also include breast screening uptake figures, this will be
escalated to Carol Colquhoun in NSS.
Action : DCE national team
It was agreed to seek final comment on the proposal from SPCCG and internally with
Scottish Government Primary Care Division.
Action: Paul Baughan (SPCCG) and DCE national Team
6.2 CRUK Primary Care Engagement Pilot
A revised proposal has been received from CRUK which has more of a focus on supporting
GP practices to develop their bowel screening action plans. The DCEPB approved the
revised plan and expressions of interest to participate in the pilot will be sent to NHS board
Executive Leads and Primary Care Cancer Leads.
Action: DCE national team
7. SOCIAL MARKETING
7.1 Lung Campaign
Gail Lyall provided an overview of the DCE lung cancer campaign creative. The campaign
will be aimed at people over 55 in the more deprived communities and will include a call to
action ‘if you’re worried about your cough, visit your GP as soon as possible’. The campaign
will air on 6th November for 2 weeks with repeat bursts throughout early 2013.
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The role of PR and field activity in reaching other target audiences (such as young women
who have never smoked) in the campaign was discussed. There will be extensive field and
PR activity to accompany the campaign.
The importance on having a cardiothoracic surgeon present at MDT was discussed and
suggested that an survey should be undertaken of coverage of CT surgeons at lung cancer
MDTs.
Action : DCE Team via Regional Network Managers
Low threshold for chest X-ray was discussed and the need for guidance to primary care for
patients who have normal chest X-ray but have persistent symptoms.
It was agreed that inclusion of guidance from Radiologists in the primary care campaign
stakeholder pack would be useful and also as an annex to the Primary Care Referral
Guidelines for Suspected Lung Cancer.
Action: Alan Cook & Hilary Dobson
The role of community pharmacists in the lung cancer campaign was discussed and how
they refer patients into primary care with lung cancer symptoms. It was agreed to discuss
with pharmacy representation on the referral guidelines group.
Action : DCE national team
7.2 Breast Screening Campaign
The programme board approved inclusion of breast screening into the DCE social marketing
programme.
A meeting with breast screening leads will take place on 10th October to discuss the direction
of the breast screening campaign. A regional pilot social marketing campaign is being
developed for Glasgow in partnership with West of Scotland Breast Screening Centre, NHS
GG&C and SG.
8. INCORPORATION OF ADDITIONAL TUMOUR GROUPS INTO THE DCE
PROGRAMME
The programme board noted the outcome of the scoring exercise for the inclusion of
additional tumour groups into the DCE programme but it was agreed that further feasibility
work be undertaken to inform the future direction of the programme before a final decision
could be taken on a recommendation to the Cabinet Secretary. This would also be informed
by an interim evaluation of the programme.
Action: DCE national team
9. DCE HEAT PUBLICATION
The programme board noted the data submission timetable and publication dates for the
DCE HEAT target. It was noted that the data warehouse IT build is complete and that the
scheduled dates for data submission were on track.
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10. DCE BOARD VISITS - summary report
Due to time constraints this agenda item was not formally discussed. The programme board
was asked to note the contents of the DCE NHS board visits summary report. The paper
provides commentary of the key themes emerging from the board visits.
11. DCE Finance 2012/13 – summary report
Due to time constraints this agenda item was not formally discussed. The programme board
was asked to note the contents of the paper. NHS boards were asked to provide a brief
evaluation of how they utilised their DCE resource allocations for 2012/13. The paper
highlights the main areas of activity, challenges and benefits realised.
12. AOCB
Clarification was asked on who the DCE Executive Lead for NHS Greater Glasgow & Clyde
would be now that Jane Grant had left. It has been confirmed that Jonathan Best is the DCE
Executive lead.
13. Date and time of next meeting
11 March 2014
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