Harrogate, Leeds and York Screening Centre

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Harrogate, Leeds and York Screening Centre

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1. Harrogate, Leeds and York Screening Centre

2. Bowel Cancer Diagnosis and Treatment The Current Picture

3. Presentation (Currently) Change in bowel habit looser Rectal bleeding Anaemia Abdominal mass Rectal mass

4. Colorectal Cancer - Diagnosis

5. Colorectal Cancer - Diagnosis

7. Obstruction

8. Obstruction

9. Ileostomy

10. Colostomy

11. Complications from fashioning stomas

12. Complications - Separation

13. Complications - Necrosis

14. Complications - Prolapse

15. Complications Parastomal Hernia

16. How Do We Improve Outcomes?

17. Service Model for Bowel Cancer Screening

18. Faecal Occult Blood test (FOBt) + Colonoscopy Two large screening studies from Nottingham and Odense, Funen (Denmark) published in 1996 showed significant reductions in bowel cancer mortality Shown to be logistically feasible in two NHS pilots in the West Midlands and Scotland First two waves of Bowel Cancer Screening Centres have started screening

19. Population Benefits 16 -18% reduction in colorectal cancer mortality Prevention of cancer in the people cleared of polyps Lower incidence of emergency presentation with bowel cancer Lower proportion of people in the community living with a permanent stoma

22. Faecal Occult Blood test + Colonoscopy Call and recall of FOBt by GP practice The positive tests (around 2%) are given Specialist Screening Practitioner (SSP) Nurse Positive Clinic appointments in Harrogate, Leeds or York SSP has a 45 minute consultation with the participant and books colonoscopy with the local screening colonoscopy unit

23. Faecal Occult Blood test + Colonoscopy SSP accompanies person to the colonoscopy Patients diagnosed with cancer are referred to the local MDT Patients with polyps are kept under surveillance according to BSG Guidelines People with a normal colonoscopy are referred back to the screening programme

24. Expected Numbers

25. Rollout Timetable

26. JAG Visits Harrogate July 2008 Accredited York November 2008 - Visited Leeds January 2009 Visit in January 2009

27. Rollout Full FOB rollout in Harrogate and York Advice from Hub for optimal staged Leeds rollout First two SSPs and Screening Centre Administrator to be appointed shortly GP and pharmacist engagement started November 2008

28. Rollout Harrogate and York Screening commences February 2009 Leeds Screening Commences April 2009 when GRS compliant

29. SSP Clinics Harrogate and York Harrogate & District NHS Foundation Trust York District NHS Foundation Trust

30. SSP Clinics Leeds Armley Moor Health Centre Parkside Health Centre on Dewsbury Road East Leeds LIFT (due to open June/July 08) It is envisaged that these sites will be reviewed via patient survey/number of DNAs to ascertain whether they are sited appropriately. Estates are able to be flexible about the SSP clinic sites in different parts of the city

31. Colonoscopy Centres / Colorectal MDTs Harrogate & District NHS Foundation Trust Leeds General Infirmary York District NHS Foundation Trust The SSPs will develop links with the colorectal CNSs and the each of the MDTs to present screening patients diagnosed with cancer and hand over to the symptomatic service

32. Health Promotion

33. Health Promotion Strategy In conjunction with Harrogate and District NHS Foundation Trust and North Yorkshire and York PCT joint strategy plan Leeds will need to target specific socially excluded and vulnerable groups Influences from other areas: Bradford found that uptake was not necessarily poor in Black and Minority Ethnic groups (although 29% in some parts of Bradford)

34. Key Tasks Provide information to ensure clear understanding Make the programme relevant to the individual Identify and overcome barriers to participation in screening Ensure consistency of message Monitor outcomes and reduce possible inequalities

35. Health Promotion Strategy Leeds will work closely with community, voluntary and faith sector. Conducting a review of current posters, leaflets and literature with these groups to form opinion to design a local leaflet/resource (with approval from National Screening Programme) Use lessons learned from other screening programmes including a social marketing approach, videos within GP surgeries (Life Channel) and initiatives such as the pharmacy campaign All approaches will be evaluated and continuing analysis of uptake undertaken when data is available

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