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Bowel cancer test scheme prevents hundreds of unneeded colonoscopies

A special test which can show if a person has almost no risk of bowel cancer is being offered to people in the Frimley Health and Care area who have symptoms, in order to eliminate the need for unnecessary colonoscopies.

So far, use of the FIT test – which is a simple faeces screen - has prevented around 200 unnecessary colonoscopies in the first six months and around 420 people a year are expected to avoid them in future.

Thanks to work across the Frimley Health and Care ICS, GPs and hospital clinicians have worked closely to roll out the scheme to the area’s two hospitals and hundreds of GP practices. Crucially, the number of people diagnosed with bowel cancer has not reduced despite fewer patients being referred.

Liz Howells, Deputy Chief Operating Officer for Frimley Health NHS Foundation Trust, said: “Working together with partners in the Integrated Care System has galvanised this work and made it possible. Previously we were working in silos and we simply did not have the relationships between GPs and hospital doctors to be able to persuade clinicians from different organisations that this was the best approach for the patient. Now we’re working together and we’re seeing fewer people referred for what is an uncomfortable procedure; we can rule out bowel cancer from the start setting their mind at rest and preventing unnecessary investigation.”

Results show that around 7-10 per cent of referrals that would previously have needed a colonoscopy now do not need to be referred. The Covid-19 pandemic accelerated the scheme as it has  allowed endoscopy clinical staff to focus their resources to patients at greatest risk. 

Around 80% of referrals for colonoscopy to the hospital have now had FIT tests before they arrive ensuring they are suitable candidates and making best use of the available resources. If GPs observe additional risk factors in a patient and have concerns they are still able to refer despite the FIT test result.

The ICS has been an early implementer of the integrated care system approach.  In 2018, teams working in cancer care came together to form a group across the ICS to lead and implement improvements in cancer care across a variety of areas. Examples include improving screening uptake, increasing earlier diagnosis and improving patient experience. 

The group includes members from the charity sector (CRUK, Macmillan) and clinical staff from primary care, secondary care and public health, with support from managers and Cancer Alliances, and involvement of patients.

During this time there have been a number of successful developments such as the improved screening uptake in hard to reach areas, implementation of community cancer navigators, and streamlined pathways for patients with suspected prostate cancer.

The FIT test is the same used for the bowel cancer screening programme.

Frimley Health and Care

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