Primary Care’s important role in cancer services

by Dr Clifford Jones, Macmillan National GP Lead Wales

I’m a GP, with a practice in Ebbw Vale and for the last few years I’ve been involved with initiatives that look at the role of primary care in cancer services.  Ten years ago not many people would consider primary care to play a major role to play in cancer services but the disease has changed.  Nowadays many people who are diagnosed with cancer are living with their disease as a long term condition and they need support out in their communities.

As well as providing long term support we also have a part to play in securing an early diagnosis for our patients and making sure they start their treatment plan as quickly as possible.  That’s how we can help save lives.

Cancer is changing, society is changing and the NHS is changing.  We are all aware of the increasing pressures facing the NHS and I’m reminded of the pressures on a daily basis – at my own practice, within my wider Health Board and by regular headlines in the media.

The media tell us we’re in crisis.  We agree, and we tell each other we’re in crisis.  Our patients worry because we’re in crisis.  But what do we mean and what are we going to do about it?

A crisis is a time of intense difficulty when important decisions need to be made.  If these decisions are not handled correctly the crisis can turn into a catastrophe.  Decisions we make now will have great and long lasting impacts.  Money is short so we need different tools to respond to our crisis situation.

Stoic philosophers believe that we become wiser by adversity.  During times of relative prosperity we get on with our work, we look after our patients, addressing problems as they arise, solving our issues, moving on.  When times are good we don’t choose to stop, take a good look and consider new ways of solving problems.  But when the pressure’s on and we have no choice, this is often the time of new ideas, innovation, collective momentum and an appetite for change.

I’ve been working with a team of GPs and Nurses on the Macmillan Framework for Cancer in Primary Care programme for the last 12 months.  During this time I’ve met many like minded colleagues from primary, secondary and tertiary care who all have the same goals in mind.  We want to make it very clear to all primary care professionals that they have an important role to play in delivering cancer services to the people of Wales.

We want to tackle those long established challenges of better integrating cancer services, and communication, between primary and secondary care.  It makes sense, it’s do-able and from what I’m seeing we’ve now got a very real opportunity to make it happen.

We’re also backed up by policy.  The Cancer Delivery Plan for Wales 2016 to 2020 talks about the importance of post treatment support and helping people to feel better supported once their acute treatment ends.  It recognises the important role of primary care to provide this support in the community and the importance of making sure that we all signpost our patients to the network of support that exists locally, whether it’s through our practice, from patient self-help groups or third sector support.

As part of the Macmillan Framework for Cancer in Primary Care we are starting to build a Framework of cancer resources for primary care.  The Framework will be available online to all primary care professionals and you can use it in whatever way you find useful for you and your practice.  Its content will be assessed and evaluated by an expert panel but we will consistently ask you what you find useful and what you don’t.  Your feedback and input will help to shape the Framework in the long term.

The Framework will cover all aspects of cancer services and is designed to be a valuable go-to resource for any primary care professional who needs information, resources, advice or anything else to help them provide the best cancer service for their patient.  We will be working on it with you, taking your advice on what you find useful and what you don’t.  You’ll be able to engage through a variety of channels, from online through to arranging to meet up with one of the team.

The Framework will go live in the Autumn of this year.

Dr Clifford Jones