PCN service specification on early cancer diagnosis 2024/25

Review referral practice

What’s required?

PCNs are required to review cancer referral practice in collaboration with partners and working to improve early diagnosis. Alliances have been allocated funding to support this work. PCNs and Alliances should develop a clear set of actions and milestones to improve referral practice for colorectal cancer, lung cancer and one other cancer type based on the burden of late stage diagnosis and opportunity for timely and effective referral to support early diagnosis.  

Supporting resources  

Teledermatology resources

• Read our skin cancer insight guide to improve your knowledge of typical features and referral guidelines for suspected skin cancer. 

• Read NHS England’s dermatology digital playbook for support on how to use digital tools that support the delivery of patient pathways.  

Non-specific symptoms resources

• Anant Sachdev, Cancer Research UK GP, highlights the importance of routinely using suspected cancer referral guidelines, despite current complexities around the management of cancer referrals.

• Neil Smith, Cancer Research UK GP, highlights the key considerations when managing people who present with non-specific symptoms. 

• Read our guide to managing non-specific signs and symptoms of suspected cancer on Doctors.net (free login required). 

Safety netting resources

Safety netting is a diagnostic management strategy that aims to ensure patients are monitored throughout the diagnostic process until their symptoms or signs are explained and results have been acted upon or their symptoms are resolved.  

• Our summary of key safety netting actions(PDF) to support primary care health professionals in practice. 

• You can use our safety netting flow chart(PDF) which provides an overview of the safety netting pathway. 

• Learn more about safety netting and our resources on our safety netting hub.  

Download our free wallet card sized leaflet to help patients who have been urgently referred with suspected cancer to prepare for their appointments and tests. 

Improving screening uptake (breast, bowel and cervical) 

What’s required? 

PCNs are required to work with partners to improve screening uptake, inclusive of breast, bowel and cervical cancer. This includes using data to understand variance in screening programme uptake, auditing non-responders to the cancer screening programme and ensuring screening history is checked at every appointment.  

Supporting resources 

• Our reducing inequalities in cancer screening guide(PDF) provides tips and information to help address breast, bowel and cervical screening inequalities. 

Screening resources

• Make sure your practices know about our Bowel Cancer Screening Good Practice Guide and the other valuable resources on our Bowel Cancer Screening Hub such as the video on ‘How to do the test’. 

• Make sure your practices know about our Cervical Screening Good Practice Guide(PDF) (2022) and look at the resources and evidence base on increasing cervical screening uptake. 

• Ensure health professionals are aware of the differences between the symptomatic and asymptomatic (screening) uses of FIT,(PDF) so they can reinforce to patients that they still need to do the test in the event of symptoms, even if they’ve recently done one for screening.  

• Practices may find our two-page bowel cancer guide(PDF) and FIT Symptomatic web page useful. Both provide an up-to-date summary of the latest guidance, evidence, and health professional resources to support the implementation of FIT. 

• Share these videos with information for people invited for screening to support their informed choice. 

• Access Breast Cancer Now’s resources for health professionals and patients. 

• These resources can be used to educate the wider primary care teams and patients on the different uses of FIT and how to complete the test in a timely manner.   

Improving health outcomes and reducing health inequalities

What’s required?

A PCN must seek to improve health outcomes for its population using a data-driven approach and population health management techniques in line with guidance and the CORE20PLUS5 approach. PCNs should work in partnership within local communities to deliver effective outreach and target care to address health inequalities that are amendable to primary care intervention.

Supporting resources 

• Our reducing inequalities in cancer screening guide(PDF) provides tips and information to help address breast, bowel and cervical screening inequalities. 

• Read our articles series on health inequalities.

• Support your patients to stop smoking by referring them to our  ‘How do I stop smoking’ page. 

• Read our screening information for trans or non-binary people. 

• Find out more about smoking cessation interventions on The National Centre for Smoking Cessation and Training website.  

PCN DES mini video series

Please note these videos were produced in 2021/22 and the content is still relevant for 2024/25, except for references to the Covid Hub and Facilitator Programme, which no longer exist. You can find out more information and support on our Health Professional website pages.

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