UK researchers used the Cancer Ongoing Review Document (CORD) – a template to guide GPs and nurses to follow-up cancer patients in a structured way – in 107 patients with a new diagnosis of cancer a six GP practices with a Macmillan GP facilitator. Over a year, when the hospital notified the practice of a new cancer diagnosis, the practice would either review the patient opportunistically or invite them for a review using the CORD.
In the 12 months after the diagnosis of cancer, 68% of CORDs were started by a GP and 32% by a practice nurse. Mean time from diagnosis to the first CORD entry was 40 days and GPs and practice nurses reported that it helped to structure consultations and provided prompts for areas that might otherwise be missed
What does it mean for GPs?
Researchers concluded that ‘a care framework akin to that for other chronic illnesses such as diabetes, is possible in primary care, as long as patients are aware that they may also seek advice at any time for their symptoms and there is excellent liaison with hospital care’.
Professor Scott Murray, study lead, GP in Edinburgh and leader of the Primary Care Palliative Research Group: ‘This would mean that practice nurses and GPs could lead in coordinating the care of patients with cancer, referring to specialists as required, like a long term conditions model. Patients value the continuity of care and the fact that the GP knows them and can deal with most illnesses. Then they can speedily refer as needed to a variety of people, including support networks in the community.’