Clinical governance in primary care
4.11 Patients should be confident in the quality of cancer care at every level. Processes for monitoring the quality of cancer care against national standards are being introduced for cancer units and cancer centres (see Chapter 6). We now need to develop equivalent processes within primary care.
4.12 Clinical governance depends upon effective audit and quality assurance. The maintenance of disease based registers is a pre-requisite for effective clinical audit. Whilst each GP will only have a small number of cancer patients to include in such a register, the population numbers at PCT level of between 100,000 - 200,000 would be sufficient to support clinical governance activity. The National Cancer Director will work with GPs to develop an appropriate primary care clinical dataset for all patients diagnosed with cancer. These datasets will form the basis for clinical audit within PCTs and will be a useful source of information for population based cancer registries.
4.13 The primary risk factors for cancer are largely the same as those for coronary heart disease (CHD) - smoking and poor diet. Primary care teams are already required to put in place a practice-based register for those at high risk of CHD. This register will help primary care teams plan and monitor the care that they offer for people at risk of cancer such as life-style advice. Accurate primary care patient registers are also essential to ensure all those eligible for cancer screening programmes are routinely invited.
4.14 GPs need ready access to up to date information on the investigation, treatment and care of patients with cancer. The new PCT cancer leads will play an important role (alongside Macmillan GP facilitators and others) in promoting continuing professional development related to cancer within PCTs.
