What can primary care services do?

There are a number of evidence-based strategies that primary health services and general practice can do to support the national cancer screening programs. These strategies exist to improve patient’s awareness of, and participation in, cancer screening and include:

• GP endorsement letters; this case study illustrates that the GP endorsed letter appears to be useful to inform and remind patients about bowel cancer screening. A copy of the endorsement letter can be downloaded in related resources below.
• Recall and reminder systems; refer to this case study for some data on recall and reminder systems.
• The use of system prompts (e.g. prompt in medical records for patients who are eligible, but have not been screened).
• Involvement of non-medical staff in organising patient and health provider reminders, patient education, scheduling screening appointments and general administrative support (including, posters in waiting rooms and in consultation rooms).
• Support priority groups (Aboriginal and/or Torres Strait Islander Peoples, culturally and linguistically diverse communities and low socio-economic communities):
  a. offer bulk-billing screening appointments
  b. have a Nurse Cervical Screening Provider available
  c. provide an interpreting service
  d. encourage women to bring a support person with them to cervical or breast screening.
  
• Display brochures, flyers and posters in the practice.
• Talk to eligible patients about cancer screening, for example breast screening;
  a. eligible women do not need a GP referral to make a screening appointment; however, a GP can fill out a GP recommendation slip and give it to the patient as a reminder to call BreastScreen Victoria to make an appointment.
• Share the key cancer screening messages, including demonstrating how to do the FOBT kit.
• Understand classifications of risk. You can find this information by referring to the clinical guidelines for cervical screening and clinical guidelines for bowel cancer screening.
• Support patients to complete the screening pathway following an initial positive screening result (i.e. referral to colposcopy or colonoscopy services). The optimal cancer care pathways (OCPs) describe optimal cancer care. They map the patient journey, aiming to foster an understanding of the whole pathway and its distinct components to promote quality cancer care and patient experiences. Access the OCP for breast cancer and bowel cancer.
• GPs can complete a GP Assessment Form to provide valuable information to the NBCSP Register about their patients.

PEN Clinical Audit Tool, or PEN CAT as it’s commonly referred to, is a clinical audit tool that allows practices to analyse data, devise the necessary strategies to improve patient care and report on quality improvement activities undertaken by the practice. PENCAT recipes relevant to cancer screening are:

• find eligible patients for cervical screening
• find patients who do not have an FOBT recorded
• find patients who have not had a mammogram recorded.

The HPV Self-Collection Audit & Quality Improvement Program aims to support general practices to pro-actively identify women who have either never had cervical screening or are lapsed screeners (more than two years overdue for cervical screening).

The audit will focus on identifying women between the ages of 30 and 74 who are more than two years overdue for routine cervical screening with a proposed outcome of engaging them in either routine cervical screening or, if they decline, to offer them the option of a self-collected Cervical Screening Test.

Cancer Council Australia has many resources available to support healthcare professionals to increase participation in the National Bowel Cancer Screening Program. The National Cervical Screening Program also has resources to support healthcare professionals including a toolkit for engaging under-screened and never-screened women in the National Cervical Screening Program.

Cancer prevention, diagnosis and treatment raise questions. We can help you answer them. Cancer Council Victoria understands the need for doctors and health professionals to be able to access the most up-to-date, evidence-based cancer information and resources which can be found on the health professional web page.

Cancer Council Victoria also run a Nurse Ambassador Program and Nurse Certification and Victorian Preceptor Program for Nurse Cervical Screening Providers. More details of these programs and how to get involved are discussed in the Nurse Ambassador case study and the Nurse Certification and Victorian Preceptor Program case study.