Cancer referrals for primary care in NSW
In February 2012, the Cancer Institute NSW launched a new website, Canrefer, which allows general practitioners and people diagnosed with cancer and their families to search for healthcare teams specialising in the treatment and care of specific cancers.
Libby Harris (pictured right) is a practicing general
practitioner (GP) who has been working as part of the Canrefer
project as the GP clinical lead. She has provided advice to
the project team in promoting the site to GPs through her knowledge
of professional networks, connections to the Royal Australian
College of general practitioners and her role as editor of a
national GP periodic journal.
Libby presented the site to the NSW Minister for Health and
Minister for Medical Research, the Hon Jillian Skinner MP, at the
launch, adding her perspective on the value of the site in
referring people who have cancer to specialists who are
members of multidisciplinary teams (MDTs).
We asked Libby a few questions to find out why she thinks Canrefer will make a
difference to GPs and people diagnosed with cancer in the
How will Canrefer make a difference to patient's lives?
When a GP accesses Canrefer to assist in referring their
patients, it should provide the patient with the most appropriate
multidisciplinary team care at a location that is acceptable to
them and ideally in the shortest possible time. Being referred to a
multidisciplinary team means patients have access to best-practice
management, with input from different specialists and allied health
evidence to show that patients who experience this type of team
care may have an improved outcome over those who do not. This may
be measured in not only their survival time but in the patient's
appraisal of the quality of care they have received.
How will Canrefer impact the clinical cancer community?
Canrefer is a directory of multidisciplinary
teams and as such will promote the existence and expansion of
these teams within the cancer community. Cancer specialists would
attest to the fact that for many years they have consulted within
the various disciplines of cancer treatment to decide the best
management plan for patients with cancer.
Canrefer formalises this network and displays it in such a way
that GPs and patients have a clear reference point, which
outlines the members of the relevant MDT and the resources
available to each team. The importance of medical and surgical
specialists, and also pathologists, psychologists,
clinical cancer nurses and palliative care specialists can give the
patient and the GP confidence that all the interests of the patient
are being taken into account.
What do you see as the main challenges in implementing Canrefer
into primary care practice?
Many GPs have established referral patterns over many years and
may need support to apply the principles of referral to an MDT for
What have you enjoyed about working on this project?
The great part about working on the Canrefer project has been
the design and delivery of a really practical tool, which can
enhance the efficiency of a GP's management of patients with
cancer. Also, being involved with a team that really understands
the time constraints GPs are under and how this resource will equip
them for sending their patients to the right service in a
How is cancer perceived in the primary health care
A vast amount of a GP's work is in the prevention of cancer.
Fortunately, each individual GP will not diagnose many cases, but I
am sure each GP remembers those they do. From giving the bad news,
dealing with the treatment issues and sometimes grieving the loss