Overview

The Derby and Derbyshire CCG Cancer Teamwork across a well-established STP Stakeholder group to implement, improve and transform cancer services. We are working with numerous Cancer Alliances and a wide range of stakeholders to:

  • improve prevention of cancer including screening programmes
  • drive the national ambition for early diagnosis of cancer
  • ensure the treatment pathways for patients are clinically effective, timely and safe
  • implement the Active Recovery Programme

Our Team

christine urquhart

 

I am the Head of Cancer Commissioning for Derby and Derbyshire CCG and also the Joined Up Care Derbyshire (STP) Programme Lead for Cancer. I work across a well-established Derbyshire network to support the delivery of the national Cancer agenda to improve our cancer pathways and ensure the best experience for our patients. Myself and my team are dedicated to the on-going improvement of cancer services to ensure we commission the best possible care for those patients diagnosed with cancer leading to better outcomes. 

 

T: 01332 868876
M: 07770794613

E: christine.urquhart2@nhs.net

ian

Text Box: Jo Rhodes__Commissioning Manager, Cancer, NHS Derby and Derbyshire CCGer­­­______

om NHS Derby & Derbyshire CCG

I support Derby and Derbyshire CCG and the Derbyshire STP to deliver the national requirements and constitutional targets for cancer care. I am passionate about our patients getting the best care, treatment and experience as possible. I have experience of working in Urgent Care and Primary Care previously and have delivered a wide range of projects and transformations within the organisation in partnership with Providers, other CCGs and clinicians.

T:  01246 514277
M: 07818 060275  

E: jo.rhodes@nhs.net

 

 

As a Senior Commissioning Officer, I support DDCCG in delivering our statutory requirements, driving transformation as well as value for money in planning and commissioning of cancer services. I am enthusiastic and have a genuine desire to improve the experience and services for the patients in Derbyshire. I have experience of working in Nursing and Quality, Primary Care and evaluating and measuring the performance of services to ensure patients receive the best care and treatment.

 

T: 07584103187
E: delores.williams@nhs.net

Text Box: Dawn Wells¬¬¬¬¬_______Senior Commissioning Officer, Cancer, NHS Derby & Derbyshire CCG

My role in the team as a Senior Commissioning Officer involves providing support to ensure that the portfolio of tasks and projects within cancer services is planned, managed and delivered effectively, and am passionate about ensuring the best outcomes for our patients within Derbyshire. My previous background was in both Primary and Secondary Care, so I have a good understanding of the challenges in both. I have experience as a Cancer Data and Performance Lead, and this enables me to provide expertise and support with data analysis. I am also a QSIR Practitioner, which allows me to help partners implement service change ideas.

 

T:  01246 514278

M: 07833 148272

E: dawn.wells@nhs.net

 

Text Box: SianSumner¬¬-______Commissioning Manager, Cancer, NHS Derby & Derbyshire CCG

Within the team my role is Commissioning Manager for Cancer.  I have over 20 years NHS experience working in secondary care prior to joining Derby & Derbyshire CCG.  Working within cancer services is hugely rewarding and knowing that I can make a positive difference drives me to seek out new challenges and promote quality improvement for both patients and staff.

T: 07768 835 605
E: sian.sumner2@nhs.net

 

Louise merriman

 

I am a GP at Clowne where I have been a partner for nearly 20 years, and for most of that time I have been involved with the cancer agenda, initially for the old PCT and then more recently the cancer lead for North Derbyshire CCG and now Derby and Derbyshire. I have worked as a clinical lead in a regional capacity for most of that time as well, initially for the old North Trent Network and now for the South Yorkshire Cancer Alliance. I continue to work in the practice 3 days a week and I think that is important when providing a Primary Care voice to discussions around cancer service provision in order to understand how cancer is addressed within Primary Care.

I feel passionately about supporting patients facing a potential cancer diagnosis and ensuring that they receive their diagnosis in a timely and appropriate way. I am very lucky to sit with secondary care colleagues to talk about service provision and pathways and it would be helpful to receive constructive feedback or questions via my NHS e-mail.

T: 01246 819444
E: louise.merriman@nhs.net

 

Text Box: Jenny Pickard______GP Lead, Cancer, NHS Derby & Derbyshire CCG

I am a GP at Crich, where I have worked for the past 2.5 years and have recently become a partner.  I have always had an active interest in cancer in terms of diagnosis, management and prevention since working in cancer clinical research prior to undertaking my medical training.  I also have an enthusiasm for population based public health medicine.  I work 3 days a week in practice and providing patient care is my primary focus.

 

I feel privileged to have recently been appointed cancer lead GP for Derby and Derbyshire (South Derbyshire) where I am well supported by the team and particularly Dr Merriman who has a wealth of experience.  I am passionate about improving patients' cancer journeys and this role is invaluable for supporting a link between primary and secondary care colleagues to enable ongoing service development.  I am always happy to receive any questions or comment via my NHS email.

 

T: 01773 852966

E: jennifer.pickard@nhs.net

 

 

Secondary Care

We work in partnership with two main hospitals, University Hospitals of Derby & Burton and Chesterfield Royal Hospital.

We work with our stakeholders and providers and improve the cancer services in Derbyshire; working closely with the East Midlands Cancer Alliance who bring together local clinical and managerial leaders who represent the whole cancer pathway. Together, we provide the opportunity for a different way of working, to improve and transform cancer services. We act on national directives in cancer care and adapt these specifically for our rural population. We work to support our service providers (GPs, Hospitals etc) achieve the highest possible patient standards across Derbyshire – always trying to improve the care we give to people with a cancer diagnosis and link services together. 

The work that we have been leading on and involved with, to support the improvement of patient care in Derbyshire includes:

Referrals from GPs to Hospitals

We have supported our Derbyshire primary care (GP) teams to make major changes to improve, in particular, the referral process.  Previously, patients were referred to the hospital who then ordered and carried out the necessary tests.  The patient would need to return to hospital for a second appointment to receive the results of the tests.  The process now is that the GP orders all necessary tests and scans to be carried out first and then reviews the results before referring a patient to the hospital.  This saves at least one hospital appointment per patient and also means that when a patient sees the consultant, the consultant has all the information and test results and is able to make a much quicker treatment plan as necessary.  It also means that should tests return an unexpected result, the GP can look at other possible causes of illness; again, this saves unnecessary hospital appointments and frustration for patients.  

Screening Programmes

Bowel Screening

FIT Testing (Faecal Immunochemical Test) across Derbyshire

The FIT test has become available for patients as part of the Bowel Screening Programme: https://www.gov.uk/government/publications/bowel-cancer-screening-benefits-and-risks/nhs-bowel-cancer-screening-helping-you-decide  The test has been developed and refined; it is much more accurate and happily, the test is also much easier and simpler to perform than the previous one.  Only one stool (poo) sample is required, and no dietary changes are needed prior to doing the test.  An abnormal result showing the presence of blood in the sample, suggests that further investigation may be needed in order to obtain the correct care.  All Derbyshire GP practices are now using FIT.

If you would like to read more about this test, please see websites below:

Cancer Research UK

MacMillan Cancer Support

Bowel Screening Programme - NHS bowel cancer screening checks if you could have bowel cancer. It's available to everyone aged 60 or over. The programme is expanding to include 56-year-olds in 2021.

https://www.nhs.uk/conditions/bowel-cancer-screening

https://www.uhdb.nhs.uk/service-bowel-screening

https://www.chesterfieldroyal.nhs.uk/our-services/bowel-scope-screening

Cervical Screening Programme - Cervical screening is available to women and people with a cervix aged 25 to 64 in England.

https://www.nhs.uk/conditions/cervical-screening

Cervical Cancer

Cervical screening Public Health England has launched its first ever national cervical screening campaign which aims to turn around a long-term decline in women getting.

The symptoms of cervical cancer are not always obvious, and it may not cause any at all until it's reached an advanced stage.

This is why it's very important to you attend all your cervical screening appointments.

Unusual bleeding

In most cases, abnormal vaginal bleeding is the first noticeable symptom of cervical cancer.

This includes bleeding:

  • during or after sex
  • between your periods
  • after you have been through the menopause

Visit your GP for advice if you experience any type of abnormal vaginal bleeding.

Breast Screening Programme - Breast screening aims to find breast cancers early. It uses an X-ray test called a mammogram that can spot cancers when they're too small to see or feel.

https://www.nhs.uk/conditions/breast-cancer-screening

Prostate - There's currently no screening programme for prostate cancer in the UK. This is because it has not been proved that the benefits would outweigh the risks. Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.

https://www.nhs.uk/conditions/prostate-cancer/psa-testing

 

What is a 2 Week Wait Referral?

2WW Referrals

There are a number of standards against which our cancer performance is measured; among these are the 2 Week Wait standards for all cancers.  A ‘Two Week Wait’ referral is a request from your General Practitioner (GP) to ask the hospital for an urgent appointment for you because you have symptoms that might indicate that you have cancer. The operational standard states that 93% of patients should be seen within 14 days of the referral. 

There is also the 62 days wait for first treatment following an urgent GP referral: this standard covers patients starting a first definitive treatment for a new primary cancer following an urgent GP referral for suspected cancer. The operational standard states that 85% of patients should receive a first definitive anti-cancer treatment within 62 days of the urgent referral date.

The work that we have been leading on and involved with will support the improvement of patient care in Derbyshire.  This includes the 2ww referral system which allows a patient with symptoms that may indicate an underlying cancer to be seen as quickly as possible. Your GP may refer you because they are concerned about your symptoms and require a specialist opinion to exclude cancer.

Tumour Sites

Breast Cancer

Breast cancer is the most common type of cancer in the UK. If it’s treated early enough, breast cancer can be prevented from spreading to other parts of the body.

Breast cancer can have a number of symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue.

Most breast lumps aren’t cancerous, but it’s always best to have them checked by your doctor. You should also see your GP if you notice any of the following:

  • a change in the size or shape of one or both breasts
  • discharge from either of your nipples (which may be streaked with blood)
  • a lump or swelling in either of your armpits
  • dimpling on the skin of your breasts
  • a rash on or around your nipple
  • a change in the appearance of your nipple, such as becoming sunken into your breast

Breast pain isn’t usually a symptom of breast cancer.

Learn more about the symptoms of breast cancer.

 

Bowel Cancer

Bowel cancer is a general term for cancer that begins in the large bowel. Depending on where the cancer starts, bowel cancer is sometimes called colon or rectal cancer.

Cancer can sometimes start in the small bowel (small intestine), but small bowel cancer is much rarer than large bowel cancer.

Bowel cancer is one of the most common types of cancer diagnosed in the UK, with around 40,000 new cases diagnosed every year.

About one in every 20 people in the UK will develop bowel cancer during their lifetime.

Read more about the symptoms of bowel cancer

 

Prostate Cancer

Prostate cancer is the most common cancer in men in the UK, with over 40,000 new cases diagnosed every year. Prostate cancer usually develops slowly, so there may be no signs you have it for many years.

Symptoms often only become apparent when your prostate is large enough to affect the urethra (the tube that carries urine from the bladder to the penis).

When this happens, you may notice things like an increased need to urinate, straining while urinating and a feeling that your bladder has not fully emptied.

These symptoms shouldn’t be ignored, but they do not mean you definitely have prostate cancer. It is more likely that they are caused by something else, such as benign prostatic hyperplasia (also known as BPH or prostate enlargement).

Read more about the symptoms of prostate cancer.

Lung Cancer

Lung cancer is one of the most common and serious types of cancer. Over 41,000 people are diagnosed with the condition every year in the UK.

There are usually no signs or symptoms in the early stages of lung cancer, but many people with the condition will eventually develop symptoms including:

A persistent cough, coughing up blood, persistent breathlessness, unexplained tiredness and weight loss an ache or pain when breathing or coughing, you should see your GP if you have these symptoms.

Read more about the symptoms of lung cancer.

Types of lung cancer

Cancer that begins in the lungs is called primary lung cancer. Cancer that begins in another part of the body and spreads to the lungs is known as secondary lung cancer. This page is about primary lung cancer.

There are two main types of primary lung cancer. These are classified by the type of cells in which the cancer starts. They are:

  • non-small-cell lung cancer – the most common type, accounting for more than 80% of cases; can be either squamous cell carcinoma, adenocarcinoma or large-cell carcinoma
  • small-cell lung cancer – a less common type that usually spreads faster than non-small-cell lung cancer

The type of lung cancer you have will determine which treatments are recommended.

Read more about diagnosing lung cancer.

Head & Neck

Head and neck cancer is a relatively uncommon type of cancer. Around 12,000 new cases are diagnosed in the UK each year.

There are more than 30 areas within the head and neck where cancer can develop, including the:

  • mouth and lips
  • voice box (larynx)
  • throat (pharynx)
  • salivary glands
  • nose and sinuses
  • area at the back of the nose and mouth (nasopharynx)

Oesophageal (gullet) cancerthyroid cancer, brain tumours and eye cancer don't tend to be classified as a head and neck cancer.

Lower Gastrointestinal

Lower gastrointestinal (or lower GI) cancer refers to cancers of the large bowel (colon and rectum) and the anus.  Large bowel cancer is the fourth most common cancer affecting men and women in the United Kingdom.  Bowel cancer is more likely to be diagnosed in older patients; more than nine out of ten new cases are diagnosed in people over the age of 50, and nearly six out of ten cases are diagnosed in people aged 70 or over.  Bowel cancer, however, can affect anyone of any age.  The chances of curing a patient of bowel cancer are highest when the cancer is diagnosed at an early stage.

Upper Gastrointestinal

There are seven main types of gastrointestinal cancer: oesophageal cancer, stomach cancer, pancreatic cancer, duodenal cancer, gall bladder and bile duct cancer, liver cancer and small bowel cancer. Together they account for approximately 11% of the cancers in the UK.

A number of symptoms such as those listed below should be discussed with your GP in the first instance. Although your symptoms may be worrying, they could be caused by other conditions and your GP will be best placed to advise you how to proceed.

Symptoms can include:

·         croaky or sore throat or hoarseness that isn't associated with a cold/flu and hasn't gone away after a few weeks

·         persistent cough

·         difficulty or pain when swallowing that doesn't go away after a few weeks

·         loss of appetite or feeling full after only a small meal

·         persistent heartburn or indigestion

·         nausea or vomiting

·         constant bloating

·         weakness or fatigue

·         a noticeable lump in the abdomen

 

 

CUP - Carcinoma Of Unknown Primary Treatment

Carcinoma of unknown primary (CUP) is a rare disease in which malignant (cancer) cells are found in the body but the place the cancer began is not known.

 

·         Sometimes the primary cancer is never found. 

·         The signs and symptoms of CUP are different, depending on where the cancer has spread in the body.

·         Different tests are used to detect (find) cancer. If tests show there may be cancer, a biopsy is done.

·         When the type of cancer cells or tissue removed is different from the type of cancer cells expected to be found, a diagnosis of CUP may be made.

 

·         Tests and procedures used to find the primary cancer depend on where the cancer has spread.

·         Certain factors affect prognosis (chance of recovery).

 

Urology

Urological cancers are types of cancers that affect the urinary tract. This includes the bladder, kidneys, penis, testicles and prostate.

Haematology

Every 14 minutes someone is diagnosed with a blood cancer and there are an estimated 240,000 people living with blood cancer in the United Kingdom today. Blood cancer is Britain's fifth most common cancer and third biggest killer, claiming more lives each year than breast or prostate cancer.

Personalised Care and Support

Personalised Care & Support for Cancer Patients (formerly known as Living With & Beyond Cancer)

The NHS Long Term Plan mandates that by 2021, where appropriate, every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support. This will empower people to manage their care, the impact of their cancer, and maximise the potential of digital and community-based support.  Every patient with cancer will get a full assessment of their needs, an individual care plan and information and support for their wider health and wellbeing. All patients, including those with secondary cancers, will have access to the right expertise and support, including a Clinical Nurse Specialist or other support workers

This new model of care serves to improve the care of patients after their cancer treatment has finished; we learned from patient feedback that more support was needed at this time, so we have made a number of changes and are working on others.  Cancer Support Workers are now in place in hospitals to work alongside clinical teams and provide extra support for patients and staff.  They contact patients following a diagnosis of cancer and work with patients identifying where assistance is needed; they are available 5 days a week and have extensive knowledge of the wider support for patients.  In addition to this, they run regular half-day Health & Wellbeing Events in the community which provide a huge amount of information and support for patients recovering from treatment.  These cover subjects such as psychological support, fatigue, nutrition, exercise and adjusting to what is often referred to as “a new normal”.

What is a Treatment Summary?

Treatment Summaries

A Treatment Summary is a document (or record) completed by health care professionals, after a significant phase of a patient’s cancer treatment. It describes the treatment, potential side effects, and signs and symptoms of recurrence. It is designed to be shared with the person living with cancer and their GP.

The Treatment Summary aims to inform the GP and other primary care professionals of actions that need to be taken and who to contact with any questions or concerns. The person affected by cancer also receives a copy to improve their understanding and to know if there is anything to look out for during their recovery.

It provides the GP with an up-to-date and clear understanding of the patient’s treatment. This can include information that is essential for updating their records and for conducting a Cancer Care Review. The Treatment Summary can also be shared with other health professionals and used to evidence the patient’s treatment, for example when claiming travel insurance. A copy of the Treatment Summary is retained in the patient’s case notes, so medical staff can access the patient's information easily if they are admitted back to hospital after their primary treatment is complete.

 

 

What is a Cancer Care Review?

Cancer Care Reviews

This is a discussion between a patient and their GP or practice nurse about their cancer journey. It helps the person affected by cancer understand what information and support is available to them in their local area, open up about their cancer experience and enable supported self-management.

When delivering a Cancer Care Review some patients may be accompanied by a carer and, with permission from the patient, they can act as an advocate when discussing their care. A carer can often help turn any recommendations into manageable solutions for the person they care for.

What is Remote Monitoring?

Remote Monitoring

Remote monitoring is a term used to describe how the specialist can schedule and monitor surveillance tests for patients who have completed treatment for cancer, without the need for a face-to-face outpatient appointment to convey the result.

 

Health and Wellbeing

Derby County Community Trust - Health Page

Health | Derby County Community Trust

 

University Hospitals of Derby and Burton NHS Foundation Trust

https://www.uhdb.nhs.uk

 

Chesterfield Royal Hospital

https://www.chesterfieldroyal.nhs.uk

 

UHDB | The Macmillan Cancer Information Centre offers information and support to patients, carers and healthcare professionals on all stages of cancer and all aspects of living with cancer.

UHDB Cancer App | ‎HealthZone UK on the App Store (apple.com)

Chesterfield Royal Hospital | Macmillan Cancer Information and Support Centre at Chesterfield Royal Hospital   

Chesterfield Royal Hospital | The App is a virtual extension of Chesterfield Macmillan Centre with useful information and support - Macmillan Cancer App

External Support

Resources for GPs