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Cancer

 

One in two people born after 1960 will be diagnosed with some form of cancer in their lifetime (Cancer Research UK). This risk increases with age, but thankfully today many people will be cured, or go on to live a long time with treatment controlling the condition.

 

Almost half of cancers are diagnosed at a late stage in England (Cancer Research UK, 2014). This means that the cancer is far along in its growth and may have spread to other areas of the body.

The following information aims to help you to:

  • reduce your chance of developing cancer;
  • recognise signs of cancer to make sure you get treatment as early as possible
  • signpost to further support, if you are diagnosed with cancer. 


On this page you will find information on:


What is cancer?

Cancer is a condition where cells in an area of the body grow and reproduce uncontrollably. The cancerous cells can invade and destroy surrounding healthy tissue. This Cancer Research UK webpage provides further information.

 

Can I reduce my risk of cancer? 

 

 

 

In the UK, around 360,000 people are diagnosed with cancer every year. We know there are over 200 different types of cancer, but do we do not know all the causes.

However, experts estimate that more than 4 in 10 cancer cases could be prevented and by making simple changes to your lifestyle you can significantly reduce your risk of developing cancer.

For example:

 

As well as the above links, the Healthy Surrey website and Change4Life website has lots of useful tips on being active and eating well for you and your family.

 

What cancer screening is available?

Screening is a way of identifying apparently healthy people who may have an increased risk of a particular condition and who will most likely benefit from it.

The NHS offers three types of screening for adults in England to help identify cancer at an early stage. These are:

  • Breast - is offered to women aged 50 to 70 to detect early signs of breast cancer. Women over 70 can self-refer via the NHS website
  • Bowel - a home testing kit is offered to men and women aged 60 to 74. If you’ve’ misplaced your kit or you are 75 or over, you can ask for a kit every two years by phoning the free bowel cancer screening helpline on 0800 707 60 60
  • Cervical - is offered to women aged 25 to 64 to check the health of cells in the cervix. It is offered every three years for those aged 25 to 49, and every five years from the ages of 50 to 64.

Further details can be found on the NHS screening website.

Screening tests are for people without symptoms. If you have symptoms, but have had a normal screening test result, you should still see your GP.

 

What cancer vaccination is available?

All 12- and 13-year-olds in school Year 8 are offered on the NHS the human papillomavirus (HPV) vaccine – boys and girls. The vaccine, helps protect against cancers caused by HPV, including:

  • cervical cancer
  • some mouth and throat (head and neck) cancers
  • some cancers of the anal and genital areas
  • protecting against genital warts.

 

It is important that girls who receive the HPV vaccine also have regular cervical screening once they reach the age of 25.

Find out more about the HPV vaccine.

 

How do I spot the signs of cancer?

Spotting cancer early means treatment is more likely to be successful. You can find out more about the common signs and symptoms of cancer on the NHS website and Macmillan Cancer Support 

You know yourself best. If you notice anything that isn’t normal for your body, go and see your GP. Encourage your loved ones to do the same.

 

What will happen if my GP suspects I have cancer?

Your GP should refer you urgently to a hospital specialist if he/she suspects that you may have cancer. You should then be contacted within two weeks of this referral being received by the hospital. 

For further information on what an urgent referral means and to prepare for your appointment look here.

 

What cancer treatment will I have?

In cases where cancer has been confirmed, you should start treatment within 31 days from when the hospital specialist has decided that you require treatment.

Surgery is a common treatment for most types of cancer, as solid tumours can often be surgically removed.

Other commonly used treatments include chemotherapy (cancer killing medication) and radiotherapy (the controlled use of high energy X-rays).

 

How can I get help to live as well as possible after a cancer diagnosis?

Improvements in the diagnosis and treatment of cancer mean that more people are living longer after a cancer diagnosis, but not everyone is living well.

Macmillan’s I've Finished Treatment webpage provides lots of advice on coping with life after cancer, and getting support. Speak to you key worker about health and wellbeing events being run locally or visit the Cancer Care Map website.

  

What is Surrey Heartlands Clinical Commissioning Group (CCG) doing to improve outcomes and survival rates for cancer patients?

By 2024, we want people in Surrey Heartlands to live healthy and fulfilling lives to reduce their risk of cancer. Should they be diagnosed with cancer we want people to be diagnosed as early as possible, to have prompt, high quality treatment and to feel fully supported throughout their journey to ensure the best chance of survival and recovery, whilst maintaining a good quality of life.

Across Surrey Heartlands, we have some positive cancer patient outcomes with 75.6% (2016) of patients surviving one year. We aim to improve one year survival rates to 80% by 2024.

Surrey Heartlands also has high reported patient experience through the National Cancer Patient Experience Survey (2018) with an average patient rating of care of 8.9 out of 10. However, there remain areas that need to be improved to ensure equity of outcomes for all patients. 

To improve outcomes, Surrey Heartlands CCG is working with system partners on a range of projects to transform pathways to diagnosis, improve patient experience and implement the 28 day to diagnosis pathways.

We are also working with partners to improve the personalised care offer to cancer patients and their families.

If you would like to get involved in Surrey Heartlands cancer work stream, please contact Becky Clack, Cancer Transformation Programme Manager on 07917 722703 or This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Useful links and services

 

 

Model Publication Scheme Class: Not part of the MPS

Learning Disabilities

What is a learning disability?

People with learning disabilities are among the most vulnerable and socially excluded in our society. It is estimated that there are approximately 20/1,000 people with mild learning disabilities and 3-4/1,000 with severe and profound learning disabilities in the UK.

Over the past three decades, almost all the long-stays in hospital for people with learning disabilities have closed and virtually all people with learning disabilities are now living in the community and depend on general practice for their primary care needs.

There is often much confusion between what is a learning disability or a learning difficulty.

Here is an explanation:

A learning disability is a reduced intellectual ability and difficulty with everyday activities – for example household tasks, socialising or managing money – which affects someone for their whole life

Someone must meet all 3 of these criteria for a learning disability diagnosis

  • Significant impairments in intellectual functioning (IQ below 70)
  • Significant impairment of social or adaptive reasoning. The person requires support to achieve their survival needs i.e. eating, drinking, planning, appropriate clothing for weather etc. and with social problem solving and reasoning
  • Impairment of onset before 14 years old.

What is not a learning disability?

  • It is not a mental illness
  • It is not Autism or ADHD in isolation. Autism is sometimes mistaken as a learning disability. Autism affects a person with their social interaction, communication, interests and behavior. Someone with Autism can have a learning disability but not always.
  • A person can have a learning difficulties on a scale might have a mild learning difficulty or a severe learning difficulty.
  • A person with an IQ score that falls slightly above 70 would be deemed to have a learning difficulty
  • The person may have a specific difficulty processing certain types of information i.e. numbers (dyscalculia), reading and writing (dyslexia), dyspraxia. These conditions are specific learning difficulties.
  • Blindness or deafness in isolation is not a learning disability. Although people with a learning disability can have, in addition to their learning disability diagnosis, have loss of hearing and/or sight)



Better working to support people with learning disabilities

Across Surrey we are working towards greater integration of health and social care for people with learning disabilities, in order to improve the service they receive.

This will mean creating a single team across Surrey County Council and the NHS, with staff receiving information and training on supporting people with a learning disability and/or autism and it will be a contractual requirement that services are able to accommodate their needs.

One of the key aims of our work is to ensure that more people can live in the community, with the right support, and closer to home.

To help achieve this, we have our county-wide Learning Disability Partnership Board, a county-wide Autism Partnership Board and the Learning Disability and Autism Programme Delivery Board.

We are also committed to service user and carer engagement and this is done through our local Valuing People groups.

 

Transforming Care

Surrey Heartlands CCG is working hard to make sure that fewer people with learning disabilities and/or autism will need to go into hospital for their care by improving services in the community.

We have plans in place for the discharge from all CCG beds for adults with learning disabilities and/or autism and, where people do need to stay in hospital, we will work to ensure their care is the best it can be so they can be discharged as soon as possible.

We have a small local Forensic community team (FIND) for people who have forensic support needs with a learning disability and/or autism and we are currently in discussion with our local providers with regards to providing settled accommodation and support for people with these needs.

We are also working in partnership with health, social care and our provider partners to:

  • Develop discharge pathways and community alternatives to hospital stays.
  • Carry out Care (Education) and Treatment Reviews (CTRS and CETRS) to ensure that all those involved in a person’s care and treatment are acting to ensure that the person can be discharged from hospital as soon as they are well enough to leave.
  • Conduct eight week visits for all adults and six week visits for all children and young people in out-of-area inpatient settings to ensure they benefit from increased focus on their care.
  • Maintain the quality of our learning disability and autism inpatient facilities. We will be working with Experts by Experience service users and carers to check the quality of our local services.

There is further information available on the following links:

https://www.england.nhs.uk/wp-content/uploads/2015/10/ld-serv-model-er.pdf

https://www.england.nhs.uk/wp-content/uploads/2017/02/easy-read-model-service-pec.pdf

https://www.england.nhs.uk/wp-content/uploads/2017/03/my-care-treatment-review-symbol-updated.pdf

 

Acute liaison and reasonable adjustments

When people are ill and need to go into hospital they may find it difficult to explain their symptoms. They may not be comfortable with the hospital environment and as a result may not receive the care they need.

Surrey Heartlands CCG is working in partnership with all our local hospital trusts in order to develop services which provide reasonable adjustments to help people with learning disabilities receive high-quality care.

Examples include making sure that every acute hospital has both adult and paediatric learning disability liaison nurses.

Please check with your local trust to see what services we have put in place to help you and your family receive the best care.

Royal Surrey County Hospital 

Frimley Park NHS Foundation Trust

East Surrey Hospital             

Ashford St Peters

Epsom St Helier                      

Surrey and Borders NHS Foundation Trust

 

Annual Health Checks

People with a learning disability often have poorer physical and mental health than other people. An annual health check can improve people’s health by spotting problems earlier.

All people with a learning disability are entitled to be registered on the GP learning disability register. From age 14 + they will be offered an enhanced annual health check.

Our new Primary Care Networks will be working hard to:

  • Increase the numbers of people with learning Disabilities having an annual flu vaccination.
  • Increase the numbers of people having the enhanced health check.
  • Reduce the use of unnecessary medication ( STOMP)

 

LeDer

Surrey Heartlands CCG is part of the national Learning Disability Mortality Review (LeDeR) Programme. The LeDeR programme is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and funded by NHS England. 

The aim of the programme is to support local areas to review the deaths of people with learning disabilities (aged four years and above), identify learning from those deaths, and ensure services are developed in order to address any learning from the review. The University of Bristol is contracted to establish and develop the review process and evaluate the findings. 

For more information on the programme please click HERE.  

Anyone can report the death of a person with a learning disability to the LeDeR programme.  All deaths of people with learning disabilities who are aged four years and above should be reported.  Deaths can be reported via:

Eileen Clark, Deputy Director for Quality and Nursing and Kathryn Fisher, Head of Integrated Learning Disability Commissioning are the Local Area Contacts (LACs) for the Surrey Heartlands CCG programme.

They can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it. and This email address is being protected from spambots. You need JavaScript enabled to view it..

 

You can read the latest LeDeR Annual Report to get an overview of the LeDeR programme and how this has been implemented in our local area. It provides an overview of the number of deaths that have been reported to LeDeR for these areas and summaries the learning that has come from the completed reviews.

 

Carer support

Providing care for someone with a learning disability can be very demanding and it is important to ensure that you make time to look after your own health and well-being, not least because in many cases carers support their loved one for the rest of their life. Across Surrey, support is available to help the person you care for reach their full potential, and to support you and your family.

Speaking to people who are facing similar challenges to you can help you make sense of things. Having a network of people who you can turn to for advice and support can be very helpful. Key to all this is understanding the rights you have as a carer enshrined in the Care Act 2014 and the Children & Families Act 2014. There are many things you will want to consider including planning for the future.

Please click here for more advice on services and support available to you.

 

Model Publication Scheme Class: Not part of the MPS

Medicines

 

Medicines Optimisation

 

On this page

  • Role of Medicines Optimisation
  • Ask your Pharmacist
  • Branded verses Generic prescribing of medicines
  • Help with health costs
  • Surrey Heartlands CG Medicines Optimisation Team
  • Antibiotic Resistance

 

Role of Medicines Optimisation

The use of medicines is the most common therapeutic intervention. It is estimated that that 15-20% of a CCG’s money is spent on medicines. Medicines Optimisation is simply looking at all aspects of the safe supply, use and disposal of medicines.

Effective Medicines Optimisation will help contribute towards:

  • Improving health
  • Improving patient care and satisfaction
  • Reducing medication wastage

Prescribing is a key component of Medicines Optimisation. Doctors or other healthcare staff accredited as prescribers can prescribe medicines for patients under their care using a written order or prescription. Whilst prescribers can decide on whatever medication they think is appropriate for the patient, they are expected to take into account the evidence for the clinical and cost effectiveness of the medicines they prescribe.

 

Ask Your Pharmacist

  • Pharmacists across provide a range of services.
  • 96% of people can get to a pharmacy within 20 minutes by walking or using public transport.
  • Community pharmacists provide rapid access, without appointment, to a healthcare professional and now offer a range of clinical and public health services.
  • Ask Your Pharmacist, it may save you making an unnecessary trip to your GP or A&E.

 

Help with Health Costs

You can find more information on prescription charges, prescription exemptions and health costs by clicking here. Please discuss the prepayment certificate with your pharmacist if you pay for your prescriptions and have to have regular prescriptions since you may be able to save money.

  • Help with Health Costs - NHS.uk site with information on help with health costs including prescription prepayment certificates.

 

Surrey Heartlands CCG Medicines Optimisation Team

Your Medicines Optimisation team is a dedicated group of pharmacists and pharmacy technicians working towards the common goal of improving the use of medicines across Surrey Heartlands. Within Surrey Heartlands there are four teams located within each Integrated Care Partnership (ICP). Our aim is to ensure that patients within Surrey Heartlands get the medicines they need to achieve the greatest health outcomes for both the individual and the local community within the resources available.

We use our experience and knowledge of medicines to ensure medicines use is as safe as possible. We constantly review new evidence and guidelines so that everyone can obtain the best outcomes from the medicines that they take.

By working closely with all members of local GP practices, our aims are to:

  • promote effective prescribing to prevent, as well as treat, disease to keep our local population healthy in future years.
  • help patients with long-term conditions, such as diabetes and heart disease, to use their medicines effectively to reduce disease progression and keep them healthier and independent for longer.
  • review new drugs that come on to the market and ensure that drugs that have been appraised by NICE are made available to those who will benefit most from them.
  • tackle the issue of wasted medicines which has been estimated to cost the NHS £300 million each year, of which £150 million is avoidable.

We also work closely with other local organisations including community pharmacies, Acute Trusts, borough councils and community health services to proactively deliver a quality service and help patients make the best use of their medicines. Read more about how we are collaborating together through Integrating Pharmacy and Medicines Optimisation (IPMO) across Surrey Heartlands.

 

Did you know?

  • If you have any unused medicines at home, you should take them to your local community pharmacy for disposal
  • If you have any queries or difficulties with your medicines you should first talk to your community pharmacist
  • Local prescribing decisions are available to view on the Prescribing Advisory Database.

 

Antibiotic resistance

Antibiotic resistance is one of the biggest threats facing us today.

  • Why it is relevant to you
     
    Without effective antibiotics many routine treatments will become increasingly dangerous. Setting broken bones, basic operations, even chemotherapy and animal health all rely on access to antibiotics that work.
     
  • What we want you to do
     
    To slow resistance we need to cut the unnecessary use of antibiotics. We invite the public, students and educators, farmers, the veterinary and medical communities and professional organisations, to become Antibiotic Guardians.
     
    Choose one simple pledge about how you’ll make better use of antibiotics and help save these vital medicines from becoming obsolete.
     
  • Visit www.antibioticguardian.com to make your pledge.

 

You can help to keep antibiotics effective.

 

 

Review Date: 2021-02-26
Review Due: 2022-02-26
Model Publication Scheme Class: Class 9: Services Commissioned

Pharmacies

 

Community Pharmacy

Community pharmacists like GPs, nurses, dentists and other healthcare professionals, are part of the NHS family. Every day about 1.6 million people visit a pharmacy in England.

Community pharmacies range from large chain stores, often on the high street or in supermarkets to smaller independently owned pharmacies often serving smaller or more rural communities. Many Pharmacies are open long hours offering healthcare advice, without the need for an appointment, when other health care professionals are unavailable.

The traditional role of the community pharmacist as the healthcare professional who dispenses prescriptions written by doctors has changed. In recent years community pharmacists have been developing clinical services in addition to the traditional dispensing role to allow better integration and team working with the rest of the NHS.

 

Out of Hours Medicines and Prescriptions

If you run out of medicine or your prescription outside of your GP surgery's normal opening hours and need some urgently even if you're away from home go to the Out of Hours Medicines page of the nhs.uk website.

 

Why should you seek the help of a Pharmacist?

As qualified healthcare professionals, Pharmacists can offer clinical advice and over-the-counter medicines for a range of minor illnesses, such as coughs, colds, sore throats, tummy trouble, earache, cystitis, skin rashes, baby teething, red eye and aches and pains. They are also trained to provide health and wellbeing advice.

Pharmacists undertake a four year Masters in Pharmacy degree course followed by a one year placement working in a pharmacy under the supervision of an experienced pharmacist. At the end of this year they take a professional examination and those who successfully complete the examination are able to register as a pharmacist.

Pharmacists have the right training to make sure you get the help you need if your symptoms suggest something more serious, for example, they will tell you if you need to see a GP, nurse or other healthcare professional.

Most pharmacies have a private consultation room where you can discuss issues with pharmacy staff without being overheard.

 

What help and services do Pharmacies provide?

Community Pharmacies provide a range of services and help ranging from:

  • A Repeat Dispensing Service. This service allows you to collect your regular repeat prescription medicines direct from your local pharmacy for an agreed period of time, without having to go back to your GP. You will need to give your permission to your GP for him/her to share information with your chosen pharmacist. When you need your prescription, instead of requesting it from your GP, you will be able to get your medicines directly from your local pharmacy.
  • Medicines Use Reviews* (MURs). An MUR is a consultation between the pharmacist and a patient that lasts approximately 10-20 minutes. It provides an opportunity for the patient to discuss how they use their medicines and to find out more about them; and the service is designed to supplement (and not replace) the more in depth clinical reviews that are conducted at GP practices. * This service is being replaced Apr 21 with the roll out of the Community Pharmacist Consultation Service
  • New Medicine Service (NMS). The service is for people who have received their first prescription for a medicine to treat any of the following conditions:
    • asthma
    • lung conditions such as chronic bronchitis and emphysema
    • type 2 diabetes
    • high blood pressure
    • conditions where you take a medicine to control the way your blood clots.
  • Disposal of Unwanted Medicines. If you have any medicines that you no longer use, you can take them to your local pharmacy for safe disposal.
  • Other services. that may be available at your local pharmacy:
    • you may be referred to a pharmacy for advice after calling NHS 111
    • emergency contraception
    • asthma inhaler use and advice
    • chlamydia screening and treatment
    • stop smoking service
    • blood pressure, cholesterol and blood sugar testing
    • substance misuse service, including needle and syringe exchange schemes
    • weight management service
    • flu vaccination

 

Useful links

 

 

Review Date: 2021-02-26
Review Due: 2022-02-26
Model Publication Scheme Class: Class 9: Services Commissioned

Eye Health and Ophthalmology

Page contents 


Eye health and care

Our community eye care services enable High Street opticians to identify and, in some cases, treat or monitor certain eye conditions. Conditions which cannot be treated or monitored by a High Street optician can be referred directly into specialist services for treatment.


Surrey Heartlands CCG has recently re-launched services with local Opticians to enable opticians (also known as optometrists) to directly refer patients with cataract, suspected wet AMD or suspected glaucoma to hospital rather than having to go via their GP. Minor eye conditions can also be seen and treated by an optician.


You will need to be registered with a GP in the following areas to access these services, identified in the table below.

*but patients will need to travel to a participating Optician in either Guildford & Waverley or Surrey Downs.


Minor Eye Conditions Service (MECS or ACES)

Currently only available at selected Opticians in the Surrey Downs area and Guildford and Waverley area – a patient must be registered with one of these GP Practices to access this service.

Minor eye conditions service 
This service covers the following conditions; red eye or eyelids, dry eye or gritty/uncomfortable eyes, inflammation and irritation of the eye, significant sticky discharge from the eye or watery eye, recently occurring flashes and floaters, in-growing eyelashes, recent and sudden reduced vision, foreign body in the eye, eye pain and excessive tears. Patients can self-refer and book an appointment simply by contacting one of the opticians using the search facility available on the Primary Eyecare website.


Other eye-care services available to patients registered with a GP in North West Surrey, Guildford & Waverley, Surrey Downs and East Surrey



Direct Pre-Operative Cataract Referral 
This service enables opticians to identify possible cataracts in patients during their routine eye test. Where an optometrist (optician) identifies cataract they will carry out an additional assessment to identify the extent of the cataract and will discuss treatment options with the patient. Patients will be given information about cataract and treatment options for consideration, before making a decision about whether to opt for surgery. When a patient has decided to opt for surgery they will be directly referred to the hospital eye department by their optometrist.

Wet Age-related Macular Degeneration (AMD) Referral
This service helps high street opticians identify suspected wet AMD in patients during their routine eye test. By urgently referring patients directly to a hospital or community clinic, further tests can be carried out and treatment can be started within two weeks if necessary.

Glaucoma Repeat Reading Service
Under this service, during a standard eye test an optometrist may identify raised intraocular pressure or suspicious visual fields which can be a sign of glaucoma. Optometrists are asked to repeat these readings/ tests to confirm a continued high or suspicious reading before making a referral. Where patients have a repeated high reading they will be referred directly to the hospital eye department.

What are the benefits of these pathways?
These pathways have many benefits to patients including faster referral to hospital, removing the need for a GP appointment and preventing unnecessary trips to hospital.

 

How do patients access these pathways 

1. MECS / ACES – currently for Guildford & Waverley and Surrey Downs patients only.

pdf List of opticians offering this service (203 KB)

pdf List of eligible GP Practices which you must be registered at to access this service. (432 KB)


Patients can self-refer and book an appointment simply by contacting one of the opticians using the up-to-date search facility available: Find a Practice - Search for your nearest participating optical practice (primaryeyecare.co.uk).

pdf Patient leaflet for Guildford and Waverley providers. (541 KB)

2. Direct Pre-Operative Cataract Referral
Glaucoma Repeat Reading Service
Suspected Wet Age-related Macular Degeneration (AMD) Referral


Patients must be registered with a pdf Surrey Heartlands GP Practice to access these services (432 KB) .

Lists of Opticians providing these services in Surrey Heartlands CCG area:

pdf Direct Cataract Referral Service (297 KB)

pdf Direct Wet Age-related Macular Degeneration Referral Providers (255 KB)

pdf Glaucoma Repeat Readings Service (302 KB)

Optometrists (opticians) will undertake the cataract assessment or repeat readings for suspected glaucoma, where required, after they have undertaken an NHS Sight Test. If you have any concerns about cataract or glaucoma please consult your optical practice.

 

Where can I find more information about these eye conditions?

For more information about eye health please visit 'NHS look after your eyes'. 

For information about cataract please visit 'NHS conditions: cataracts'. 

For information about glaucoma please visit 'NHS conditions: glaucoma'. 

For information about AMD please visit 'NHS conditions: AMD'.

For information about minor eye conditions service please visit 'primary eye care: minor eye conditions'.

 

Model Publication Scheme Class: Class 9: Services Commissioned
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