This area provides information and resources for Primary Care Professionals and Primary Care Networks (PCNs) to support the early identification and referral of patients with suspected cancer. 

Given the shared focus on Early Cancer Diagnosis within both the Directed Enhanced Services (DES) Specification, and Cancer Quality and Outcomes Framework Quality Improvement indicators (QOF QI) this section specifically outlines national and local resources to support PCNs and individual practices in delivering both the DES Specification and QOF QI.

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The QOF QI focuses on practices identifying improvements in both cancer screening and referrals which then feeds into the DES requirements.

The following presentation describes all of the requirements and some ideas as to how these might be achieved.

Click here to access and download the presentation, which you can then watch and hear narration from CMCA Primary Care Lead, Dr Debbie Harvey.

The Alliance produces regular bulletins with information for Primary Care Networks, GPs and other primary care professionals.

Please see them below:

To sign up to receive the bulletins, please email:

Network Direct Enhanced Service (DES) Specification 2021/22

This year’s PCN DES for the early diagnosis of cancer reflects the ambitions of the DES for 20/21 but with an additional focus on recovery following the pandemic.
The key aspects of the DES are outlined below and discussed in the accompanying presentation.

  • The NHS Long Term Plan sets out that by 2028 the proportion of cancers diagnosed at Stages 1 and 2 will rise from around 50% to 75%. This will, in turn, improve 5yr survival
  • Achieving early diagnosis requires a whole systems approach with the focus of primary care being improving referral practice for suspected cancer and encouraging participation in national cancer screening programmes
  • In the first wave of COVID 2ww referrals dropped significantly. There has been some 2ww referral recovery, but this has not been the case for all tumour pathways eg lung, urology. Identifying, diagnosing and treating these missing cohorts will be a priority in 2021/22
  • Primary care will have a key role in continuing to grow public confidence in the safety & availability of general practice services, including the availability of face-to-face consultations where required

Resources for each Section of the DES