The aim of this Locally Commissioned Service (LCS) is to provide enhanced support for prostate cancer patients in the community, including annual holistic needs assessments (HNAs) and prostate-specific antigen (PSA) monitoring, which will also encourage and facilitate the transition of care of men with stable prostate cancer out of the acute hospital setting and into primary care.

This supports the strategic objectives of improving patient experience, moving care closer to home and delivery of productivity savings, and will provide patients with a more holistic approach to their care, closer to their own homes.

GPs who have signed up to the LCS will be required to provide this service as set out in section 3 of the service specification.

Patients will be transferred following secondary care assessment for suitability and will be accompanied by treatment summaries which include patient-specific protocol for PSA monitoring, any consequences of treatment (medical, physical and psychosocial) and instructions for ongoing management. 

Practices can also search via EMIS for stable prostate cancer patients who meet the eligibility requirements and invite them for a HNA and a PSA test, as per the LCS, in order to receive payment. Practices can download the clinical template and import it into EMIS. 

Another cohort of patients eligible for this LCS are the patients that have already been discharged by secondary care to general practice who have prostate cancer and need an annual follow-up. These patients would also qualify for a £50 payment once they’ve had their PSA and HNA completed. In order to do this, practices would have to do a computer search for all the patients who have a diagnosis of prostate cancer, then each individual set of records has to be looked at to identify if the patient has been discharged by urology. Typical yield for a practice of 10,000 patients would be approximately 20 patients, potentially earning a practice £1,000 if all the patients concerned get their PSA test and HNA completed during the financial year.

Practices who have FY2 doctors or GP registrars may wish to potentially discuss the logistics of this exercise with them as a possible QIP or audit project.

Where practices do not wish to participate in this locally commissioned service for their patients, the ICB will make appropriate alternative arrangements for those patients. These arrangements are outlined in Appendix 9 of this specification. It is expected that the service is offered to all patients unless patients choose to opt out.

This LCS has been developed with the support and agreement of the London Cancer Urology Board and NCL acute trusts (UCLH, RFL, WH and NMUH). Systems will be in place to facilitate the smooth transfer of suitable patients to primary care practices in Barnet, Camden, Enfield, Haringey and Islington for follow-up.

Personalised Care and Support Plan code addition

The NCL Prostate Cancer Stratified Follow-Up LCS template has been updated to 2022-23 Prostate Cancer Service Specification.

An annual year of care payment of £50 per patient who meets the criteria and is coded with SNOMED codes 1034421000000103 and 787261000000106 and are being managed in line with the requirements as set out in the service specification.  

If you have any queries, contact a member of the NCL Cancer Team.