Call for a Kit Clinic Evaluation Update 2016/17
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- Blaise Reed
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1 1 Call for a Kit Clinic Evaluation Update 2016/17 Call for a Kit Clinics (CFAKC) involve inviting known non-responders to meet with the Health Promotion specialist to discuss how to complete the kit and any barriers to taking part in the screening programme. If the person is in agreement a replacement kit will be ordered from the Hub. This paper gives updated evaluation of the clinics held from April 2016 March 2017, which has formed the majority of the teams health promotion plan over the year. Number of nonresponders invited Number of people seen Number of kits ordered Number of kits completed The above information shows: 86% of people invited to CFAK clinic attend 89% of people attending CFAK clinic have a kit ordered 51% of people attending CFAK clinic subsequently complete the kit Number people DNA, cancelled or unsuitable 51% - 58%(previous evaluation) of people complete a kit after attending CFAKC appointment compared to other initiatives including 35% in GP practice face to face, 20% following telephone advice and 11% where practices send a letter. In 2016/17, 24 clinics have been held in 21 GP practices within Lancashire, with priority being given to the practices with the lowest bowel screening uptake.
2 2 During 2016/17, 344 males were seen in the clinics compared to 286 females. 64% of males who ordered a kit went on to complete the test compared to 59% of females. Urdu, Punjabi, Gujarati and English were the four main languages used within the clinics. It has previously been identified that the decision whether or not take part in the first screening invite has a significant bearing on whether that individual will take part in the screening programme in future rounds. As part of CFAKC, GP practices are recommended to prioritise year olds when identifying individuals to invite. By targeting the younger age group the intervention is likely to have a more sustainable effect on future uptake as those individuals will be eligible to take part in screening for longer.
3 3 Although the younger age range is targeted, many of those seen in the clinic are persistent nonresponders to the bowel screening programme. The above chart shows the number of people who completed a kit following the clinic who had previously never engaged with the programme. Outcome of kit ordered following CFAKC Negative Positive Spoilt kit Weak Positive Positivity rate of 1.2% in individuals who completed the kit following CFAKC. Positive results Of the 4 positive results, 1 person was subsequently diagnosed with bowel cancer. This person had previously not engaged with the programme in any of the previous screening four rounds but did participate following the invitation to the call for a kit clinic. In addition to the 4 positive results, there were 20 weak positives and 2 spoilt kits. Number of Reasons people gave for not having completed the kit respondents "just not done the kit" 227 "never received the kit" 102 "too busy" 56 "didn t know how to complete the kit" 55 kit not due" 42 "refused to complete the kit" 33 other health problems 32 "forgot to do the kit" 29 didn t know about the kit" 26 have done the kit in the past but did not know it was 11
4 4 every 2 years "fear of cancer / unknown" 6 fatalistic attitude" 5 currently in the BCSP system" 4 lost the kit 3 cannot handle poo 2 never heard about the BSCP 1 It is interesting to note that over 100 people reported that they had not received the kit. This is an area that the team will explore further over the next 12 months. Not knowing how to complete the kit is another major barrier highlighted by attendees. In Conclusion Further to this 2016/17 update the overall figures for CFAKC since it s introduction shows: Total from August 2015 March 2017 CFAKC data: 41 CFAKC held in GP practices No of patients invited (84.69%) No of patients seen 895 (87.40%)- No of kits ordered 535 (59.77%)- No of kits completed 237 FTA, Cancelled/Unsuitable 489 negative results 9 positive results (1 Bowel cancer) Full live data available on request The project has been an immensely huge success across Lancashire. Low uptake GP practices have been very keen to engage with the BCSP Health Promotion Team. Most of the practices request more CFAKCs in their practices but due to capacity at present the team are only able to offer 1-2 sessions. Due to success of the project the team are now expanding the project with an additional part-time GP/Community engagement post in 2017/2018. This post will help coordinate and further develop the infrastructure to aid engagement with the GP practices and facilitate more CFAKCs across Lancashire. The CFAKC project has had national recognition as well by being invited to poster present at the CRUK Early Diagnosis Conference in February The project has also been invited to poster present at the PHE NCRAS Cancer Data and Outcomes Conference 2017: Using data to drive services. Regionally the CFAKC project has also been shared with LA/NHS service providers from Bradford, Manchester, Kirklees, Liverpool and Towel Hamlets. Thank you to the BCSP board members, BCSP team, PHE/NHS England, Rugby Hub team and all the local GP practices for supporting this exciting project. 2017/18 priorities for Lancashire Bowel Screening Health Promotion Team Further deliver the Call for a kit clinics in the next cohort of lowest uptake GP practices in each CCG across Lancashire Formal evaluation of the CFAKC in partnership with Edgehill University Present findings at national, regional and local conferences
5 5 Explore models of expanding the CFACK model across Lancashire esp supporting CRUK to train Cancer Champions in Primary Care settings. Support and help facilitate the Involving Communities Increasing Uptake Conference 'Examples of Bowel Screening initiatives across the North West' Support 3 events in partnership with LCC to raise awareness of BCSP in care/residential homes in Lancashire Authors: Kathryn Jones NHS England Screening & Immunisation Coordinator Sadiq Patel BCSP CVS Community Engagement Officer Shahida Hanif BCSP Health Promotion Specialist
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