Earlier diagnosis to reduce emergency hospital admissions in Cancer and Cardiovascular services

Strategic clinical networks in the South West are coordinating work across cancer and cardiovascular services to look at why opportunities to diagnose and treat patients at the earliest opportunity are missed. A quarter of cancer patients are currently diagnosed following an emergency admission to hospital and go on to have poorer outcomes than those who are diagnosed during an earlier stage of their illness. Similarly in cardiovascular services there is evidence to show that earlier diagnosis and intervention could reduce premature deaths and disability; and help to reduce the level of hospital admissions for these patients.

The Cancer Network is looking to understand the reasons behind late diagnosis and also to provide a better understanding of the management of patients diagnosed following an emergency admission. The information obtained will help to improve the evidence base for the development of acute oncology services across the South West. A pilot project is currently being undertaken in 13 acute trusts in consultation with CCGs and it will be rolled out across the South West in early 2014.

‘By doing this audit and closely examining the reasons as to why this group of patients cancer diagnosis is delayed we hope we can all work together to remove obstacles, whether in primary or secondary care, to improve outcomes.’
Helen Thomas, Clinical Director, South West Cancer SCN

The Cardiovascular Network is developing the Opportunities to Prevent Admissions (OPrA) project initially focussing on four areas;
• Reducing amputations in people with diabetes
• Preventing admissions to hospital with acute kidney injury
• Reducing the number of people suffering a stroke linked to atrial fibrillation (irregular heart beat)
• Reducing the number of people repeatedly admitted to hospital with heart failure

The OPrA project will involve a root cause analysis of the current hospital admission patterns and follow patients through primary, secondary and, where applicable, community services to identify where improvements in care could prevent admissions and complications. Each of the four areas will be piloted in a specific locality with the intention of sharing the learning between acute trusts and CCGs across the South West.

‘We want the focus to be on preventing emergency admissions to hospital, which are both expensive to the NHS and distressing to people with long-term cardiovascular conditions. Our OPrA project aims to improve the working between hospitals and GPs so that opportunities to prevent hospital admissions are identified and learnt from. That way fewer people living with diabetes, kidney or heart disease, or stroke end up with complications, which can often be life-changing.’
Martin James, Clinical Director, South West Cardiovascular SCN