Living in a deprived community can greatly reduce a person's life expectancy and whilst survival rates from cancer are increasing in the UK as a whole, the rate of improvement is slower in more disadvantaged areas.

This has been attributed to a number of factors, including patient delay in recognising signs and symptoms of cancer and poor levels of knowledge about the disease and its outcomes.

Britain does not compare favourably with other European countries and the Government has set targets to reduce this health inequality.

The Improvement Foundation has been commissioned by the Inequalities Unit, Department of Health to work with a total of nineteen spearhead PCTs in two, two-year cohorts (waves). The first wave consists of ten spearhead PCTs in 30 specific communities covering a total of around 330,000 people and will be completed in September 2009. The second wave consists of nine spearhead PCTs in 30 specific communities covering a total of around 390,000 people.

Focusing on the early presentation of bowel, breast and lung cancer, the aim is to increase the number of people seeking advice, and encourage and support them to seek treatment earlier, as well as advocating the importance of bowel and breast screening.

As part of this the PCT teams will identify and deliver locally-tailored ways of raising awareness about the risk factors and the benefits of earlier diagnosis.

Who is involved

The PCTs involved in the first wave of the programme are:

• Gateshead, Newcastle, North Tyneside, South Tyneside and Sunderland in North East England
• Halton & St Helens, Manchester, North Liverpool, Central Liverpool and Salford in North West England

The PCTs involved in the second wave of the programme are:

• Barking & Dagenham, Haringey, Lewisham, Newham in the London area
• Bury, East Lancashire in North West England
• Leicester City, Nottingham and Stoke-on-Trent in the Midlands

There are three community teams in each PCT, consisting of local residents who have volunteered to be involved working with service providers. These vary from area to area, but include public and voluntary organisations.

What we are doing

The collaborative method views local people as the key to understanding how their communities work. It brings together local people with service providers to work in close partnership to achieve the goals of the programme.

There are two strands to the cancer programme:

• Working with GPs to improve early diagnosis in primary care and referral for investigation, in accordance with best clinical practice. Information is submitted by each participating GP practice on a monthly basis to help them to track their progress in monitoring and treating more people. The local project manager and team members work together with the practices to make any improvements that are required.
• Work in the local communities to help educate and raise awareness of the symptoms of cancer, and when people should get in touch with their GP. The teams test ways of delivering health-related information in an understandable and acceptable way, to get people to present to their GP earlier. Teams gather information about their community to better understand the people living there and the level of service provision.

In order to share and increase learning all 30 teams will meet together three times during the programme.

Each site is supported by a programme support co-ordinator from the Improvement Foundation and an on-site project manager.

The programme is overseen by a national programme board which includes members from the Department of Health, the Treasury and the Local Government Association.

The national policy on cancer is set out in the Cancer Reform Strategy on the Department of Health’s website.

There is also key information in the Department of Health's The NHS in England: Operating Framework 2008-09.

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