I’m Lorraine Sloan, Primary and Community Care Programme Manager at Macmillan Cancer Support.

Macmillan understands the challenges GPs face, both in identifying possible cancers and also in supporting people living with cancer.

Macmillan has worked with GPs now for about twenty years. We work specifically with GPs who have an interest in cancer.

They in turn provide practical solutions to help other GPs who don’t have a strong interest in cancer

and may benefit from their expertise.

These video clips are intended to give you some insights into some of the work of Macmillan’s Primary Care Community.

As a GP, I know how important it is, if someone comes to see me with symptoms that might mean they have got cancer

that I refer them quickly for a specialist opinion.

This means that if they have got cancer, it is more likely to be diagnosed at an early stage

when it can be more easily treated.

There are lots of different types of cancer and lots of different symptoms that people can have.

We have a lot of guidelines to help us GPs with the referrals.

But sometimes I find it difficult to remember all the details of all the referral guidelines

so I am really glad that Macmillan GPs have developed this very useful desktop tool

which summarises all the cancer referral guidelines for me.

I keep this tool on my desk by my side so I can refer to it easily if I need to, if someone has come to me with symptoms that might mean cancer.

Now that I have checked in this tool, I realise that George’s symptoms mean that he might have colo-rectal cancer.

so I organise an urgent referral for him to be seen by our local colo-rectal cancer specialist within the next two weeks.

As George’s GP, one of the things I found really useful in helping me to care for him is the Treatment Summary.

This is produced by the hospital; often the consultant or the nurse specialist who is involved in the patient’s care

but it is a project that started with the Macmillan GP Advisers

who developed a template with all the information that we would find most useful to help us care for our patients

when affected by cancer.

It gives a whole load of different bits of information for us;

the diagnosis, what stage of illness when they are first treated,

as well as the treatment they have had and what we might expect after this treatment.

Side effects, symptoms and late effects that may develop even years after the patient has been treated.

With this prompt, we can remember about those.

It also gives us examples of symptoms when patients come back to us

that may be significant and may represent a recurrence of their illness

and need to be acted on quickly.

As well as other information that will prompt us to look after our patient better

and prompt us when we do the cancer care review.

As George’s GP, I am contractually obligated to review him within 6 months of his cancer diagnosis.

However, I like to review my cancer patients much sooner than that

and what the Macmillan GPs have provided me with is the perfect tool

to have conversations with George about things that I may not even have considered.

Things for example, like how he is doing financially and whether there may be any benefits implications for that.

Or who is looking after him at home

and whether there are issues about who is caring for him or whether they need some extra support.

And also more information about his treatment, his diagnosis

and using the information that I have got from the Treatment Summary

that allows me to have a really good and full conversation with George about things that might impact on his future care

and on his current situation.

As George’s GP, how can I ensure that everybody from out-of-hours, paramedics included,

are fully aware of his needs?

So that they are aware of his DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) status,

of his preferred place of care and where they can access drugs out-of-hours?

Well, Macmillan have a toolkit called the Out-of-hours (OOH) Toolkit which addresses those exact issues you just raised.

It covers four main areas: One area is communication. So we can advise people on how they can inform their patients

and their relatives on who to contact in a problem out-of-hours

as well as informing other healthcare professionals, like Out-of-hours GPs what to do because they don’t know that patient.

Drugs access is a big problem because out-of-hours, chemists are shut.

So again, it gives us ideas on systems that are used across the UK which are working effectively.

The resuscitation status that you mentioned before; there are a lot of issues, ethical issues around that.

The toolkit advises people on the decision making process and even systems that have been developed that work properly

so that Do Not Resuscitate orders are in place and therefore the patients and the relatives aren’t put under any distress.

Finally, education is a very important issue that underpins all of this.

It helps educate our GPs and our nurses to understand these processes and provide better symptom control

and to think ahead, what we call anticipatory care.