Improving prostate cancer surveillance in primary care

Iddawela S, Prince R.

Plan

• Active surveillance of prostate cancer is a key aspect of long term management in primary care.

• A quality improvement project was undertaken to establish thesethresholds, set up monitoring pathways and invite patients to participate in annual reviews focussed on prostate cancer

Do

Patients who have prostate cancer in a single GP practice in the West Midlands –identified those discharged

Patients were invited foran annual review, with an offer of an examination.

Monitoringand PSA thresholds established

Study

• 5/41 lost to follow-up –2 from private sector

• 18/41 discharged

• 7/18 (39%) had no monitoring thresholds

• 1 patient –PSA above threshold, several occasions and missed

• 4/18 (22%) patients accepted invitation for review –only 2 consented for physical examination ACT

• NHS services contacted to reinstate follow-up

• NHS consultants and/or services consulted regardingmonitoring thresholds– including patients from private sector

• Patients referred on urgent pathways for missed follow-up

• Communication with clinical directors regarding transfer of care upon discharge

• Mechanisms for practice recall and updating the cohort were enacted

Key Takeaways

• Poor continuity of care in the private sector and difficulty re-establishing contact

• Need for clear and consistent communication between secondary and primary care at point of discharge

• Continual revisiting in primary care and offer of physical examinations in addition to PSA