Local support offer to GPs for Bowel Cancer Screening Programme

Dear General Practice Colleagues,

To support the improvement of uptake in Bowel Cancer Screening, we are writing to all GP practices in London with some guidance and key contacts in each borough in London.

This communication is to make you aware of the support you can get from your local Health Promotion Specialist as well as to remind you of the current pathways for symptomatic and asymptomatic (screening programme) patients.

***For action: Health Promotion Specialists in your area***

Every bowel cancer screening centre has a Health Promotion Specialist (HPS), employed to mitigate and address barriers to attendance in London; with a focus on reducing inequalities, improving uptake, patient communication and access, and partnership working. 

Below are collective examples of initiatives HPS’ have supported practices with. These initiatives are evidenced to improve uptake to the bowel cancer screening programme. Please also see the attached case study.

• Tailored support in addressing non-responders.
• Attend PCN meetings and provide up-to-date practice screening uptake data and relevant insights about Bowel Cancer screening pathway.
• Bring the relevant health equity audit to the PCN and exploring targeted and bespoke interventions, developed in collaboration with GPs, in addition to outreach activities within GP surgeries.
• Staff training about the screening service:
  • Prevalence, signs/symptoms, risk factors and prevention of bowel cancer
  • The role of the Bowel Cancer Screening Centre and the patient pathway
  • Common barriers to screening and tackling health inequalities
  • Supporting patients accessing reasonable adjustments
  • Searches for non-responders to the screening invitation
  • Enable staff to confidently promote bowel screening
• Adding reasonable adjustment flags to patient records and pulling off patient lists for non-responders.
• Engagement with patients identified, or accessing support in the local area, to ensure reasonable adjustments are in place for the Bowel Cancer Screening Service.
• Telephone/conversation scripts and letter/text templates to support discussions with patients about Bowel Cancer Screening.
• Bowel screening resources in other languages and formats (including easy-read materials).

If you would like specific information about how your practice or PCN may be supported, please directly contact the HPS in your respective locality.

Cancer Screening Pathway

A FIT (Faecal Immunochemical Test) is sent to people aged 50-74 every two years. People aged 75 + can request a kit. Invitations to be screened and the FIT Kits are sent from the London Hub via post. The London Hub will send the patient’s results to them by letter and inform their registered GP practice of the results electronically. The patient will then remain in the screening pathway until they are no longer eligible.

Bowel Cancer Screening Resources // Bowel Cancer Screening: Information Leaflets// Campaign Resources // NHS BCSP Information for Patients // Video: How to use the bowel cancer screening FIT kit

Symptomatic Pathway

Patients who present with symptoms of bowel cancer will enter a different pathway from those who are on the screening pathway. The FIT used has a lower threshold for determining a positive result (10µg Hb/g faeces). The pathway begins with a general practice consultation, after which – if there are concerns about potential bowel cancer, the primary care clinician requests a FIT (faecal immunochemical test) For the patient. Once the result is received by the practice, the clinician manages as appropriate (which would include urgent referral to a specialist in secondary care in the event of a positive result).

Screening & Symptomatic Pathway Map – March 2025

For more information please see the PCN DES guidance (Part A, clinical), section 2.1.11 which focusses on cancer referral and screening.

Kind Regards,

Adult Screening Commissioning Team, NHSE London Region

england.ypa@nhs.net