Views of primary care physicians and oncologists on cancer follow-up initiatives in primary care: an online survey

Introduction Primary care physicians (PCPs) are playing an increasing role in the follow-up of cancer in England. In 2003 a Cancer Care Review (CCR) was introduced to ensure contact between PCPs and cancer patients within 6 months of diagnosis. The NHS also intends to introduce survivorship care plans (SCP). The aims of this study were to: describe current practice and views in primary care with respect to the CCR and information provision from secondary to primary care following final discharge from hospital follow-up; and to seek views on the perceived usefulness, content, and feasibility of a SCP. Methods An on-line questionnaire survey of 100 oncologists and 200 PCPs. Results Half of PCPs undertook the CCR opportunistically, and only 64% had an agreed structure. Forty percent felt the CCR was useful for the doctor, and 60% useful for the patient. Most PCPs and oncologists think a SCP would be useful, but only 40% oncologists thought that it would be easy to produce. At discharge from follow-up, more than half of oncologists said they provided information on histology, treatment, requirements for screening and sur-veillance, and referral guidance. Less than half provide information on potential late effects and symptoms of recurrence. PCPs felt that information on all of these areas was important and that the information they receive is often inadequate. Discussion/Conclusions The CCR has not been implemented systematically. There is support for the introduction of a SCP and broad agreement on content. However, careful planning is needed to ensure all necessary information is included and to overcome barriers of implementation. Implications for cancer survivors Further research should explore what cancer survivors would find useful in a primary care-based CCR and what should be included in a SCP. This should be clearly communicated to the relevant health care professionals to maximise the benefits cancer survivors and their families gain from these policy initiatives.