Community pharmacy pilot to focus on spotting patients with early signs of lung cancer

Four sites in England will focus on lung cancer as part of the ‘NHS supporting early diagnosis of cancer’ pilot service.
man coughing into elbow

A community pharmacy pilot service will focus on identifying patients with early signs of lung cancer, Amanda Doyle, national director for primary care and community services at NHS England, has told MPs.

The ‘NHS supporting early diagnosis of cancer’ pilot, which The Pharmaceutical Journal reported in March 2024 had made its first referrals, is intended to enable community pharmacies to refer patients with ‘red flag’ cancer symptoms directly to secondary care or rapid diagnostic services, without the need to visit a GP.

Steve Brine, chair of the House of Commons Health and Social Care Select Committee, requested an update on the pilot service at the final hearing of the committee’s pharmacy inquiry on 26 March 2024.

Doyle responded that the pilot areas had “started the initial work” and were looking at the mechanisms for pharmacies to refer into local cancer pathways.

“There are four pilot sites in total: Cornwall and Norfolk have started, to be followed quite soon by Greater Manchester and south east London,” she said.

She added that “all the pilots will focus on lung cancer” and patients would be referred if they repeatedly presented at community pharmacies with symptoms, such as a cough.

Additionally, she said that some of the pilot areas would refer patients with suspected head and neck or gynaecological cancers, with “flags” including repeated sore throat, swollen glands, sore mouth or patients asking about side effects of hormone replacement therapy.

Doyle highlighted that the pilot service “is not about replacing GP surgeries with pharmacies or passing people around to different services”.

“This is about opportunistic identification in high risk places of people who might have worrying symptoms.”

She added that the pilot was intended to refer more people into services than actually had cancer because “that’s the best way to get them diagnosed at an early stage when they’re treatable and potentially curable”.

Doyle said that people living in deprived communities are “significantly more likely to have their cancer diagnosed at a later stage”.

“For these communities, it’s doubly important that we take any opportunity at all to pick up worrying signs and symptoms early and get people into the right pathways,” she added.

When listing the four areas taking part in the pilot service, Doyle did not mention Thames Valley Cancer Alliance, which was one of five cancer alliances originally planned to be included in the pilot.

David Dean, chief officer at Community Pharmacy Thames Valley, told The Pharmaceutical Journal: “We are still waiting for an update from the Thames Valley Cancer Alliance.”

A spokesperson for the Buckinghamshire, Oxfordshire and West Berkshire Integrated Care Board told The Pharmaceutical Journal in March 2024 that Thames Valley Cancer Alliance was “still working to scope out the feasibility” of its pilot of the service.

Last updated
The Pharmaceutical Journal, PJ, April 2024, Vol 312, No 7984;312(7984)::DOI:10.1211/PJ.2024.1.307784

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