What is the challenge your project is going to address and how does it connect to the theme?

Cancer is a major cause of mortality worldwide accounting for 10 million deaths in 2020. In the UK, over 166,000 cancer deaths occur annually  and the 5-year survival is significantly lower than other countries in Northern Europe .  The COVID-19 pandemic has had a substantial detrimental effect on cancer detection and treatment with an estimated 39,000 fewer patients diagnosed and 300,000 fewer 2-week wait cancer referrals compared with pre-COVID years . Health inequalities compound delays in cancer diagnosis: more people  in deprived areas are diagnosed with cancer and at a later stage compared with more affluent areas.

There is an urgent and growing need to address  these missing diagnoses and increase capacity within the system. Community pharmacists are an untapped resource that can contribute to the earlier, faster and more equitable detection of cancer symptoms and their onward referral for investigation.

Technology is an enabler to service innovation where complex variables and decision support is needed.

What does your project aim to achieve?

The overarching aim of this project is to co-produce a community pharmacy-based service to support the early detection of cancer (hereafter referred to as CPEDC )

Objectives include:

To adopt a multi-stakeholder approach to co-design the referral service from community pharmacy

To explore how the use of  technology can facilitate this referral service

How will the project be delivered?

This work builds on the scoping review that we conducted examining over 40 publications on community pharmacy (CP) based cancer related initiatives from 15 countries . These studies support the premise that CPs can support access to earlier diagnosis.

This proposal will adopt a multi-stakeholder approach for co-production of the CPEDC and will include three tasks:

1. Multi-disciplinary co-production, including modified Nominal Group Technique (NGT) followed by a Delphi process, of key components of the CPEDC. Findings will be contextualised to Bristol – an area of high-deprivation, difficult-to-reach populations, which typically have later stage diagnosis and remain  under-represented in cancer screening programmes.

Participants will include patient/public representatives, CP personnel, GPs, oncologists and commissioners.

2. Results from task one will support derivation of a list of user requirements needed in  digital interventions  that can provide decision support for  CP staff involved in this service. This will be compared against existing digital platforms for decision support in oncology

How is your project going to share learning?

The dissemination strategy will involve targeting a variety of audiences including academics, health professionals, policy makers and commissioners using different media.

It’s important to target all because the early detection of cancer is a national priority that has featured in the latest government white papers. Therefore, the output of this work can be used to plan for nation wide implementation feasibility studies and pilots.

The academic dissemination will take place through an open access publication and conference presentations.

The health professional dissemination will take place through professional organisation events and communications such as British Oncology Pharmacy Association, Royal Pharmaceutical Society among others

A project advisory group will be formed to guide and support the work. This will consist of community pharmacists, oncologists, GPs, policy makers and commissioners who will also support the dissemination of the results.