I write as an experienced GP, suddenly plunged into the world of a cancer patient and wish to reflect on the importance of a strong continuing GP–patient relationship throughout the cancer journey, and the role of QOF cancer care reviews in facilitating this process.
As a GP I have often experienced a mix of professional satisfaction and guilt when I’ve made an unsolicited phone call to a patient to perform a cancer care review. The usual driver for the call was to tick the QOF box, but, as the conversation has unfolded, patients have invariably expressed appreciation for the call and, although there is infrequently anything specific they have needed from me, it has been helpful to offer reassurance that I am available, should the need arise in the future.
Hurtand et al highlight the risk of loss of continuity of care with a GP around the time of, and in the year after, a cancer diagnosis.1 As a GP, I had assumed that this was because of patients being absorbed into the hospital system, with multiple appointments and good support from cancer specialist clinicians. Although this is true in part, as a patient I have experienced a reality that is more mixed. I have encountered numerous skilled and caring professionals, but have also recognised that they work within a system that is stretched and struggling to meet the demands placed upon it. Nowhere is this more apparent than the MDT process where the need to discuss large numbers of patients can result in rapid decision making and in the patient voice being marginalised. At worst, vital decisions can be taken by clinicians who have never met the patient.
As I’ve had my personal challenging encounters with this process, I have come to appreciate the value of a GP who knows me and my illness, and is able to listen and, where necessary, advocate for me. QOF cancer care reviews can provide a valuable doorway allowing patients to access this support. As a patient, I vote that they should remain.
- © British Journal of General Practice 2019
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