Tips and tricks for achieving DES

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Under Review — this page was due to be reviewed by Friday, 31 May 2024. The information shown here may be outdated.

This page provides some tips and tricks to help primary care achieve the Directed Enhanced Service (DES) metrics related to cancer for 2023-24.

Primary care networks (PCNs) may wish to review their referral practice against the recommendations of NICE guideline 12. Reviews can take the form of:

Actions to help increase uptake in cervical and bowel screening could include:

The use of faecal immunochemical tests (FIT) in those with NG12 colorectal cancer symptoms (excluding anal/rectal mass or anal ulceration) should be used to inform referrals. It is expected those with a FIT result fHb <1 0μg Hb/g, a normal full blood count and no concerning symptoms are safety netted in primary care or referred on a non-urgent pathway where appropriate. Visit the FIT service page for more information.

Cancer alliances have funding to support FIT implementation, which can be used to purchase FIT kits.

See also:

See the guidance published by the British Association of Dermatologists and the NHS on new models of service for teledermatology. See also the best practice timed pathway for skin referrals.

New technology, such as teledermatology, digital referral platforms and the use of remote consultations via Consultant Connect can reduce the need for unnecessary hospital attendances, improve the speed of diagnosis for patients, and improve productivity while providing the same level of access to high-quality care, diagnostics and treatment.

It is expected that cancer alliances will deliver referral activity that reflects at least 75% population coverage of non-specific symptom pathways by March 2023. For more information, see the Rapid Diagnostic Centres service page.

See also the NHS Cancer Programme Faster Diagnosis Framework.

PCNs should:

  • work with local partners (e.g. cancer alliances, commissioners) to understand the non-specific symptom pathways available in their areas and the model for referrals
  • identify and undertake specific actions to encourage practices to refer using their non-specific-symptom pathway, where available and appropriate
  • raise awareness of the non-specific symptom pathways within practices.

Review date: Friday, 31 May 2024