Cancer Decision Support (CDS) tool

The Cancer Decision Support (CDS) tool is designed to support GPs in their clinical decision making and encourage them to think cancer by displaying the risk of a patient having an as yet undiagnosed site-specific cancer. This risk is based on read coded information from their patient record including symptoms, medical history and demographic data.

Accessing the CDS tool

Macmillan is working with each of the main GP IT providers to integrate the CDS tool, please see below to find out whether the CDS tool has been integrated into your system. Alternatively, email us for more information.

CDS software integration update


We are pleased to announce that in Emis version 5.9, the QCancer® risk score prompts and the symptom checker template are now available.

The QCancer tool was developed to assist clinicians with the early identification of risk factors associated with cancer. It uses Julia Hippisley-Cox’s QCancer algorithm to produce a risk score based on the individual’s current signs, symptoms and risk factors.

All EMIS Web users in England and Wales are now able to access an updated version of the tool in EMIS Web 5.9. This includes risk score prompts, the Symptom Checker template, an additional template to record QCancer Outcomes and Follow Up, and new Safety Netting searches. In this update, the alert triggering threshold has changed from a 5% composite risk score, to a site specific score of 2% or above.

For further information on how to activate the prompt function or access the active symptom checker and follow up templates, please visit the EMIS Health support centre and login using your EMIS Web credentials if you're based in England, or your Support Centre credentials if based in Wales. 

Email us for further information on the QCancer tool.


INPS Vision

We are pleased to announce that the integrated INPS Vision CDS tool is now available to all Vision users across the UK. This tool uses Willie Hamilton’s RAT algorithm and can be found within the consultation workflow. For further information on how to activate the tool please visit the Vision+ Help Page.


TPP SystmOne

Due to internal reorganisation at BMJ Informatica, the original CDS tool is no longer available as a free download for TPP SystmOne users.

We are currently working with TPP SystmOne to integrate the CDS tool into their system, so that it will be available free of charge to all SystmOne users. As we are in the early stages of development with SystmOne, we do not as yet have a release date confirmed. If you would like your details to be added to the TPP SystmOne mailing list, so that we can update you when the integrated version of the tool becomes available, please email us.

If you are an existing BMJ Informatica customer, or would like to purchase a package to include the CDS tool before the integrated version becomes available, please email us.


Your questions answered

How do these tools relate to NICE (NG12) for suspected cancer?

What does a 3% CDS risk score mean?

What evidence is there that the tool works?

What do I do if the patient has a risk score greater than 2%, but does not meet referral criteria?

Does the CDS tool increase cancer diagnosis?

What are the likely implications of the CDS tool on the number of referrals into secondary care?

Am I obligated to act on a risk score?

CDS Promotion Pack

This pack will equip you with the knowledge and understanding to use the tool and present to peers, thereby supporting the dissemination and adoption of the CDS tool in general practice.

For more information please email us.


Throughout 2013, Macmillan worked collaboratively with BMJ Informatica to develop and pilot an electronic cancer decision support (CDS) tool. Part funded by the Department of Health, the project aimed to help support GPs in their clinical decision making when referring patients with suspected cancer. To help GPs ‘think cancer’.

We tested the CDS tool with over 550 GP practices across the UK to ascertain its usefulness and appropriateness to incorporate within a standard 10 minute consultation. The aim being to raise awareness among GPs of cancer risk, while helping support their decision making in ‘low risk but not no risk’ consultation cases, as well as those higher risk cases. Following the success of the pilot, Cancer Research UK (CRUK) produced an executive summary of the project [PDF].

The Prevention and Diagnosis team won The Cancer Care Patient Safety Award for the electronic CDS tool in July 2015. Their poster also won a rosette for Best in Innovation at the Royal College of General Practitioners conference in October. View the poster [PDF].

(the CDS tool) made us think a bit more deeply…it’s probably made me more aware of symptoms which I may have not been as aware of in the past.

GP from England using the eRAT tool