Spreading the Benefits of Local Awareness and Early Detection Initiative (LAEDI)

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Context

Cancer causes 36% of under-75 ‘avoidable deaths’. When cancer is diagnosed at an early stage, chances of a full recovery are greater - 93% of people survive early bowel cancer for five years, only 7% if it is found at a late stage. Earlier diagnosis in most Long Term Conditions leads to lower treatment costs and better survival outcomes.  

LAEDI is an NHS England funded partnership project of GP peer-to-peer education, which supports practicing GPs in visiting outlying surgeries to share best practice in screening, detection and conversion rates and been has shown to successfully reduce variation and inequalities in cancer screening. These transformational priorities have been determined after the review of CCG plans, HWB Strategies, JSNAs and widespread stakeholder engagement including events and Commissioning Assembly.

The priorities are agreed and will be monitored through the Oversight and Planning group which includes all key partners. The areas will be addressed by groups consisting of clinicians, commissioners and other partners such as Public Health and Health Education Wessex

5 Year Strategic Vision

Wessex SCNs are in a unique position to tackle variation in primary care outcomes across the whole of the region.  As part of this, GP practices identified as being outliers in the 2012/13 GP practice profile data will be assisted to reduce variation in screening and early detection of long term conditions through peer to peer support using the established LAEDI model.  

It has been agreed that some of the LAEDI funding can be used for other Long Term Conditions whilst continuing the current cancer work plan. 

This project aims to encourage greater uptake of screening programmes and prompt, appropriate referral from primary care. A primary care education programme will support national campaigns and reduce regional health inequalities by targeting local areas of poor outcomes or low uptake of health care services.

Year 1

Objectives:

  • Increase bowel cancer screening uptake across Wessex.
  • Proof of concept will then be rolled out across Wessex.
  • Increase access to colorectal endoscopy services equitably across Wessex.
  • Transfer learning from cancer early detection programme to improve early diagnosis of other long term conditions.
  • Reduce inequality in health care screening in Wessex.

Delivery:

  • Work with Public Health and the bowel cancer Screening Hub to identify and support GP Practices with lowest bowel cancer screening rates to engage hard to reach groups.
  • Roll out pilot ‘safety netting’ for screening across Wessex for bowel cancer.
  • Shape the colorectal diagnostic pathway, including scoping capacity and future demand for endoscopy services in collaboration with the AHSN by Dec 14
  • Expand previous specialist GP focus on cancer to introduce specialist GP visits to support practices identified as bottom quartile for LTC management.
  • Identify, through screening pilots and surveys, the reasons for variation in uptake of screening and with public health, develop tools to improve engagement in hard to reach population groups, for example people with SMI.

Improved:

  • Increase rates of bowel cancer screening to ensure practice average in Wessex of 60% target by 2015.
  • Deliver phase 1 (dementia) LAEDI visits to practices identified within areas of poor outcome by Mar 15.
  • Demonstrable reduction in inequality of uptake of screening (average) across Wessex.
  • Increase rates of all cancer screening uptake by 5% by 2015 from 2012 baseline in patients known to have SMI.
  • Increase in dementia diagnosis rates in line with the 2015 diagnosis ambition rates.

Year 2

Objectives:

  • Roll out pilot ‘safety netting’ for screening across Wessex for all cancer.
  • Wessex pilot and evaluation to inform national strategy.
  • Close the gap of screening and early diagnosis of long term conditions between mental health patients and the rest of the population across Wessex.
  • Increase access to colorectal endoscopy services equitably across Wessex. 

Delivery:

  • Work with Public Health and the bowel cancer Screening Hub to roll out screening safety netting across Wessex.
  • Share learning for hard to engage groups across Wessex to increase practice uptake of screening for all cancer and LTCs.
  • Primary care education on equity of access to screening.
  • Support commissioning of capacity changes across Wessex to ensure staff and equipment are available to deliver equitable access to endoscopy and flexi sigmoidoscopy across Wessex in collaboration with AHSN and Health Education Wessex. 

Improved:

  • Reduce number of colorectal cancers diagnosed via emergency admission by 5% by 2016.
  • Increase proportion of new colorectal cancer diagnoses at Stage I or II equitably across Wessex by 5% by 2016.
  • Reduce average cancer mortality in Wessex by 1 year by 2017.
  • Increase in dementia diagnosis rates in line with the 2015 diagnosis ambition rates
  • Increase rates of all cancer screening uptake by 10% by 2016 from 2012 baseline in patients known to have SMI.