Service case study: Doncaster’s lung health service pilot showcases pharmacy’s cancer pathway potential

Published on: 22nd June 2017 | Updated on: 28th March 2022

Cancer Research UK has published the evaluation of a pilot service which community pharmacy teams in Doncaster undertook with the aim of improving the diagnosis of lung cancer and other lung abnormalities.

It was recognised that Doncaster had a much higher than average incidence of lung cancer between 2012 and 2014, with patients often presenting with late stage cancer. Community pharmacies in Doncaster were considered a good place to engage people who do not regularly consult their GP and may not seek GP assistance until their symptoms are severe, at which point they may have late stage lung cancer. This therefore led Doncaster Clinical Commissioning Group to pilot a service whereby a small number of pharmacies could directly refer patients for chest x-rays if the patients met certain criteria.

What did the service involve?

Medicines counter assistants in community pharmacies would identify individuals presenting at the pharmacy who met the inclusion criteria, for example, if they were a smoker with a persistent cough. They would then refer these patients to the pharmacist for a consultation to ascertain whether they met the criteria for referral to the local acute trust for a chest x-ray; if not, they were advised to see their GP.

What does the evaluation show?

The findings are based on qualitative and quantitative data and are drawn from an evaluation survey and face-to-face discovery interviews with participants involved in the project.

A total of sixteen patients presenting to pharmacy were identified, had a consultation and were offered a chest x-ray. Six of the patients declined the x-ray and ten attended Doncaster & Bassetlaw Hospitals NHS Foundation Trust for an x-ray. No patients were diagnosed with lung cancer; however, one stable lung condition was confirmed.

The evaluation highlights many benefits that the service has brought, such as:

  • a radiologist highlighted that the pharmacists’ referrals had been exemplary, legible and included all relevant medical history;
  • the importance of appropriate non-medical referrals was recognised as crucial to establishing how community pharmacy was perceived locally;
  • it was perceived that the process of identifying patients eligible for the service and directly referring them for a chest x-ray, when implemented, worked well; and
  • a number of participants highlighted that the process for the service fitted well into their existing roles even though it was outside their normal day-to-day focus.

The evaluation concludes that it is possible that normalising health interactions with pharmacists beyond their current role is an important step for supporting healthcare in primary care.

Information on this service and other cancer services is available on the Community Pharmacy England Services Database. This service is also featured in Cancer Research’s recently updated Pharmacy training for early diagnosis of cancer report.

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