Groundbreaking Cancer Programme

Under a ‘National Awareness and Early Diagnosis Initiative’, launched by the Department of Health last week, work is already underway in the UK to improve public awareness and fast referral of cancer, with pilot schemes in 20 Primary Care Trusts (PCTs) run by the Improvement Foundation.

The Improvement Foundation is working with 20 PCTs* in 60 specific communities. The first wave of the two-year programme will be completed in September 2009; the second wave continues until August 2010. Focused on early presentation of lung, breast and bowel cancer, the aim is to increase the number of people seeking advice, and encourage them to seek treatment earlier. As part of this the PCT teams identify and deliver locally-tailored ways of raising awareness about the risk factors and the benefits of earlier diagnosis.

There are two strands to the cancer programme:
• Work in the local communities to help educate and raise awareness of the symptoms of cancer, and when people should get in touch with their GP. The teams test ways of delivering health-related information in an understandable and acceptable way, to get people to present to their GP earlier.
• Working with GPs to improve early diagnosis in primary care and referral for investigation in accordance with best clinical practice.

Through this programme, the Improvement Foundation supports local people in deprived areas, raising their expectations and helping them to drive improvement in their own communities, working closely with local clinicians and voluntary agencies. Meetings are held in community centres, pubs, clubs, bingo halls and mosques. The aim is to get people to start talking about bowels and breasts and coughs, to find out what people know about cancer and to stimulate discussion.

The Improvement Foundation's approach views local people as the key to understanding how their communities work. This programme is unique to the Improvement Foundation and is not being done anywhere else in the world.

Early results indicate there has been a statistically significant increase in referrals via the two week system for all three cancers. This is likely to be as a result of increased numbers of people with symptoms suggestive of cancer presenting to general practice, having been stimulated to do so in the community. These earlier presentations will result in lives saved.



• Living in a deprived community can greatly reduce a person's life expectancy; whilst survival rates from cancer are increasing in the UK as a whole, the rate of improvement is slower in more disadvantaged areas
• Britain does not compare favourably with other European countries and the Government has set targets to reduce this health inequality
• A key element of inequality is access - those who don't have it and those who have it but don't use it, for a variety of reasons.
• One clear example of the critical nature of increasing equality in the public health system revolves around the early presentation and rapid diagnosis of bowel, lung and breast cancer - people with any of these three types of illness stand much better chances of survival if the cancer is caught early.


The Improvement Foundation

The Improvement Foundation's work has covered nearly 35 million people in the UK with estimated savings to the NHS of £33m per year. The company was formed in 2000 to help frontline public service providers to improve and redesign the services they provide to their patients and the public using improvement methodology and techniques that originally came from non-healthcare industry. The Improvement Foundation leads the field in service improvement work across the public sector in the UK and overseas. Experts in quality improvement, the Improvement Foundation has an eight-year track record of demonstrating significant, sustainable impact and value for money.  


* PCTs involved

The PCTs involved in the first wave of the programme are: Gateshead, Newcastle, North Tyneside, South Tyneside and Sunderland in North East England; Halton & St Helens, Manchester, Salford, North Liverpool and Central Liverpool in North West England. (Note that North Liverpool and Central Liverpool are now both part of ‘Liverpool PCT').

The PCTs involved in the second wave of the programme are: Barking & Dagenham, Haringey, Lewisham, Newham in the London area; Bury, East Lancashire in North West England; Leicester City, Nottingham City and Stoke-on-Trent in the Midlands. The final site is to be announced shortly.


Please click here to read more about this programme of work.


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