General Practice and Cancer Control

Around 90% of the population will visit their General Practitioner (GP) at least once a year. Through these visits, patients will access a variety of services including diagnostic and specialist services. General practice is vital to the provision of high quality care to the Australian population and is one of the cornerstones of the health system.

The Role Of General Practice in Cancer

The role of general practice in all aspects related to cancer is of great importance. GPs are recognised as playing a fundamental role in the prevention of cancer, screening for cancer, diagnosis and initial referral to specialist services. In addition, GPs are involved in the ongoing multidisciplinary care of people affected by cancer. It is estimated that the average GP working in Australia will encounter four to five new cancer cases each year and will have about sixteen to twenty cancer patients in their care.

Where are we heading?

The Cancer Pathways in General Practice workshop identified a number of areas where the Institute could provide education, training and support for General Practitioners and Practice Nurses. This involves the provision of relevant and timely information for cancer patients their families and carers. A report of the findings from this workshop is now available.

Many GPs have highlighted the need for education and resources that are more relevant to their needs. As new technologies emerge, e.g bowel screening, GPs also need to know what this will mean. The Cancer Institute NSW is committed to the development of resources for primary care to support better communication and coordination of care.

Cancer Leads Project

A formal, collaborative partnership between the Cancer Institute NSW and the Alliance of NSW Divisions has been established. As part of this partnership, a strategy that focuses on cancer in general practice is being implemented.

Following an Expressions of Interest process, Cancer Leads have been appointed in ten NSW Divisions of General Practice to:

facilitate the delivery of cancer related professional development activities;
provide relevant cancer related information for general practice;
liaise with local cancer services; and
become recognised as a Cancer Lead with their peers.

Divisions with Cancer Leads are implementing projects addressing various aspects of cancer prevention, screening, early detection or care and management, in a manner that is responsive to the needs of the local population. Cancer Leads working within participating divisions are actively involved in the implementation of division projects.

Division	Project Description
Central Coast	Provision of multidisciplinary education on prevention and management of cancer in primary care, provision of opportunities for participation in an established smoking cessation clinic. Coordination of practice nurse mentoring from CNCs and development of electronic communication between GPs and cancer services.
Dubbo Plains	Implementation of a skin cancer awareness campaign and screening in local practices. Development of effective working relationships with cancer services stakeholders in the region to improve communication processes between cancer services and general practice.
Mid North Coast	A culturally appropriate smoking cessation model will be delivered to ATSI community members. The project will also support regular GP attendance at multidisciplinary palliative care meetings and provide opportunities for undertaking clinical placements within cancer care.
Murrumbidgee	Nurse-initiated strategies will be implemented to optimise the care and management of patients with a cancer diagnoses. The strategies will focus on GP coordinating systems for those who have had treatment for cancer and require: clinical monitoring and evaluation; progressive symptom control; multidisciplinary support and/or palliation.
New England	Workshops to increase GPs knowledge and skills in the management of melanoma and non-melanoma skin cancer. Increasing education and up-skilling GPs in palliative care.
Northern Rivers	Locally based training and resource support for GPs and practice nurses to implement systems improvement and practice-based models for smoking cessation.
Northern Rivers	Integration of GPs with local breast cancer multidisciplinary team meetings and the subsequent primary medical care needs of patients. A nurse will undertake case management to provide liaison between GPs and the MDT.
NSW Central West	Provision of CPD on pain management and the post chemotherapy management. Establish systems to ensure implementation of current best practice guidelines. Liaison with GWAHS to encourage communication between cancer services and general practice.
Riverina	Promotion of appropriate screening for bowel cancer to those at increased risk. This will occur in three stages: Assessment of services; General practice training; and Promotion of bowel screening, including resource development.
Sutherland	Enhancing skills and knowledge in the management of pain and the care of patients in the palliative phase of the disease. Provision of a cancer package to GPs that is relevant and locally focused. Improving communication mechanisms and referral systems with specialist services.
Tweed Valley	Liaison with local cancer services and allied health to improve general practice awareness of services available. Development and implementation of systems to improve service coordination and communication between stakeholders.