O/T Rotherham 3rd worst place for early cancer diagnosis

[great_fire]

More great news for people living in Rotherham, in terms of percentage of stage 1 and 2 cancers diagnosed early we are the third worst in England, think next time I need to go to a hospital and the doctor asks which hospital I want to go to I think I'll say either Hallamshire or the Northern General.

Rotherham really does seem to be one of the worst places to live in the entire country at the moment though sadly.

Here's the figures:

Percentage of cancers diagnosed early (stages 1 and 2)
WORST 10
Area %
Eastbourne 33.9
Hastings 33.9
Rotherham 34.4
Middlesbrough 35.2
Leeds 35.3
Swale 35.3
Newham 35.6
Tower Hamlets 35.7
Merton 36.0
Chesterfield 36.0


TOP 10
Area %
South Cambridgeshire 61.5
Huntingdonshire 61.0
Bedford 60.3
South Norfolk 58.9
Babergh 58.9
Colchester 58.9
Broadland 58.8
St Edmundsbury 58.5
Uttlesford 58.4
North Devon 58.1

Apparently the main hospital in Huntingdonshire is the only privately run DGH, maybe a bit of private money in the NHS is not such a bad th

[kempo]

It's a,disgrace that we are amongst the worst in Europe for early detection of cancer.

The problems start at the GP level...GPs all have a protocol of symptoms for urgent 2 week referal of possible cancer symptoms.

If we look at practice referal rates into the 2 week system we would see that although the practice populations are similar, referal rates have wide variation.

This data has been available for years but not acted on because decision making in the NHS is finance driven and not outcome driven.

GP practices work under a downward pressure on referrals and may even be rewarded on low referal rates!

The next problem occurs at the secondary care stage ie hospital..the 2 week referal system for cancer patients is designed for an outpatient referal to a consultant but many hospitals have missed out the consultant seeing the patient and substituting direct access investigations.

If these initial investigations are normal then the patient is returned to the GP without being seen

[jolly_roger]

Two interesting lists, very generally speaking the "bad" list are areas with high immigrant levels, the "good" list are areas with low immigration levels.

Or maybe just deprived v affluent?

[great_fire]

[quote="jolly_roger" list are areas with low immigration levels.

Or maybe just deprived v affluent?[/quote]

There must be more demands on areas with high immigration, I know that must have contributed to the trust in South London that went bust a year or two back.

[kempo]

Jolly of course is no fool...he just acts like one.It can be assumed in so called deprived areas that advice does not get to the population or is not responded to.

Of course other European countries have areas of deprivation but our figures match the worst of Eastern Europe...this applies to early cancer and childhood deaths.

The cause is of course multifactorial but we must not ignore poor medical care.

The problem with our NHS is its good at bigging itself up...best in the World etc but every time any outcome figures come out for just about any common serious illness it turns out that we are one of the worst in Europe.

[stevemiller]

Jolly of course is no fool...he just acts like one.It can be assumed in so called deprived areas that advice does not get to the population or is not responded to.

Of course other European countries have areas of deprivation but our figures match the worst of Eastern Europe...this applies to early cancer and childhood deaths.

The cause is of course multifactorial but we must not ignore poor medical care.

The problem with our NHS is its good at bigging itself up...best in the World etc but every time any outcome figures come out for just about any common serious illness it turns out that we are one of the worst in Europe.

Kempo, would you say that GP's in affluent areas are more likely to investigate a patients ailments more objectively than a GP in a deprived area who may always be on his/her guard that a patient is just after a note for work.
That's not knocking GP's, it just seems a hurdle to get over before taking someone serio

[kempo]

It's complicated Steve and obviously as said due to a collection of reasons.I think you have produced yet another ie GPs in deprived areas will exhibit different behaviour to GPs in affluent areas.

It could also be assumed that the better doctors get jobs in the better areas.

Middle class patients are more knowledgeable and perhaps more demanding that there symptoms are taken seriously and more likely to have worked out the correct management plan for themselves.

My particular interest is looking at the quality of care by doctors and I think the system creates mediocrity and a mindset of box ticking, target reaching, money earning as opposed to a drive towards quality.

[stevemiller]

From what you say I get the impression a GP is under various pressures NOT to pass borderline cases up the ladder, financial, waiting lists etc.
Not ideal. Yet when cases hit the media it's GP incompetance rather than the system that's at fault.

[kempo]

From what you say I get the impression a GP is under various pressures NOT to pass borderline cases up the ladder, financial, waiting lists etc.
Not ideal. Yet when cases hit the media it's GP incompetance rather than the system that's at fault.

There is indeed downward pressure on GPs to cut their referal rates and often financial incentives to do so.

[jolly_roger]

it's simple maths really.

Like organising a buffet for 100 people and 125 turn up. The sandwiches have to stretch further.

Ditto the health service, if an area (for example Tower Hamlets) has an infrastructure for x people but if those turning up at the door are x plus some more then the service is spread very thinly.

Add to this the lack of education and the problem that those attending dont have english as a first language then the overall effect is what you see in those tables, no matter how hard working and dedicated the medical staff try to be.

It's no coincidence that the best achievers in that list are mainly low population areas with a predominantly white middle class and low immigration levels.

...and aren't labour controlled areas.