MERTON CCG – FAECAL IMMUNOCHEMICAL TESTING ANNOUNCEMENT

18th June 2019

We are pleased to announce that Faecal Immunochemical Testing (FIT), as a diagnostic tool for primary care, will be made available on the 20th June 2019. FIT will be a far more sensitive method of testing for bowel cancer, in comparison to the previously used Faecal occult blood test (FOBT). Ultimately, FIT will have many clinical and patient experience benefits.

As a result of FIT being introduced, Epsom and St Helier Trust (ESHT) has now removed the ability for London GPs to use FOBT as a diagnostic tool. As we gear up for the launch of FIT, we encourage that, prior to launch, Merton GPs begin to order FIT tests prior to the launch date (a nominal number of 10 in the first instance, additional kits can be ordered after the launch date), for the applicable cohort of patients (as per the NICE DG30 guidance). This is so that we can minimise the level of delay in the service being rolled out, and to ensure that Merton aligns with the updated Pan London lower GI two week wait referral form (which already includes a section for FIT stratification). The latest lower GI referral form will be available on DXS (please see below a link to some communications explaining the changes seen in the newest version of the lower GI two week wait referral form).

If you have problems with accessing FIT kits, and you suspect that a patient has bowel cancer, please refer the patient using either the older version of the two week wait lower GI referral form (which is also available on DXS), or the latest version of the lower GI referral form (if using the latter, GPs will need to include as much information as possible to avoid potential rejection in the absence of FIT pre-launch).

As additional support, Cancer Research UK will be providing, to those who request it, GP practice visits on the Tuesdays and Fridays between 19th June to 19th July. We highly encourage that practices utilise this opportunity, so please contact the email addresses below to express your interest in having a practice visit.

More news will follow on FIT in the following weeks, including at the Merton locality meetings scheduled to take place on the 19/20th June. In the meantime, if you have any questions, feel free to get in contact with mikathomson@doctors.org.uk or Andre.Chagwedera@swlondon.nhs.uk

Please note: the FIT threshold used in screening (120ug/g) is different to FIT thresholds in symptomatic patients (10ug/g). This means that patients who have a negative screening result may still have bowel cancer and should be offered a symptomatic FIT test if appropriate.

You can also find below a useful safety netting template that GP practices can use. We highly encourage using this safety netting FIT template, as it will allow for GP practices to monitor and stock take the FIT tests have been administered. It is also CQC, appraisal, and audit friendly.


Resources

Communications explaining the changes seen in the newest version of the lower GI two week wait referral form

Cancer Research UK Infographic explaining the key differences between FIT as a diagnostic tool for symptomatic patients, and FIT in relation to the national bowel cancer screening programme

Safety Netting Template