None of us have the time. We’re all busy. Right now we’re fighting our way through the flu vaccines (or lack of them), putting on our battle armour in preparation for 2019, and trying to make an educated guess as to how many staff are likely to be ‘off sick’ during the winter.
So there’ll be a general rolling of the eyes and a gasping of “You’re kidding!” when I suggest that we should add something else to our workload. But please don’t stop reading yet!
A few months ago I read some information on the Cancer Research website about bowel screening and specifically about engagement with primary care services. Initially I groaned a little to myself; did we really have the time and resources to write to patients who hadn’t bothered to respond to the pack they’d received about bowel screening? Was it really our responsibility to remind them? Shouldn’t they be the ones to take the initiative about their own health? However, it niggled at me. When a GP writes to a patient asking them to reconsider having the test, bowel screening goes up between 6 and 12%. I’m constantly banging on about preventative work – how general practice needs to try and stop patients from coming into the practice in the first place (don’t all laugh at once!). What I mean is that so much work could be done with patients, from supporting them with obesity problems to alcohol consumption and smoking on a preventative level. This type of work could dramatically reduce the burden on our services. Some work is being done already but not enough in my view.
It didn’t sit comfortably with me that after reading these statistics we didn’t do something ourselves, so I put together a simple letter, imported it into the clinical system with an automatic read code and asked an administrator to send a reminder letter every time we had a notification that a patient hadn’t taken up the offer of bowel screening. The letter tells the patient to go direct to bowel screening for the kit, so no further input is required from the practice.
We haven’t carried out any ‘official’ data searches yet, but I know that already one person has been found to have bowel cancer when previously they didn’t know – someone who ignored the routine request that came through the mail, but when they got a letter from their GP practice signed by the senior partner (pp’d by the admin staff, of course) decided to get the test done and discovered the early onset of bowel cancer. The workload involved in sending these reminders is about ten minutes. And apart from the very important fact that it detected cancer early on, in terms of general practice it has saved appointment and follow-up time because at some stage this patient was likely to develop symptoms that would have been investigated by general practice.
By doing a small amount of preventative work, the practice not only saved on resources, we saved a person’s life.
Author: Dwysan Edwards
Download a copy of the bowel screening follow up letter to personalise for your practice here.