Cancer DES (Direct Enhanced Service)

This section focuses on the important contribution Primary Care Networks (PCNs) and their practices make to improving early cancer diagnosis and addressing cancer inequalities.

To follow is an overview of the main contractual workstreams PCNs are involved with to support early diagnosis i.e. the Primary Care Network Direct Enhanced Service (DES) – Section 8a and the Impact and Investment Fund. We have included a range of guides, resources and practice examples to help progress work.

Cancer Alliances have a responsibility to work with PCNs to establish priorities and workstreams across the region to achieve the DES. We have developed a range of planning and support mechanisms, including the PCN Facilitator team and the Primary Care Community of Practice.

Find your PCN Facilitator:

Area	PCN Facilitator
Northumberland/ North Tyneside	Interim Fiona Anderson
Newcastle/Gateshead	Emma Shaw
South Tyneside	Sarah Kucukmetin
Sunderland	Leanne Rowell
County Durham	Emma Sarsfield
North Cumbria	Joel Vilchez
Tees Valley	Angela Atkinson

 

Primary care community of practice

The aim of our group is to support PCN work on earlier diagnosis of cancer and improve patient experience of cancer pathways. At the meetings our team will facilitate sharing information about specific pathways, developments and opportunities and address challenges and topics raised by the group.

The community of practice meets on MS Teams for one hour every two months on the second Wednesday from 1:00pm – 2:00pm. Contact us for more information.

Introducing the Early Cancer Diagnosis – Primary Care Network Direct Enhanced Services (PCN DES)

The 2025/26 DES contract notes that PCNs now have four core objectives:

1. Co-ordinate, organise and deploy shared resources to support and improve resilience and care delivery at both PCN and practice level.
2. Improve health outcomes for its patients through effective population health management and reducing health inequalities.
3. Target resource and efforts in the most effective way to meet patient need, which includes delivering proactive care.
4. Collaborate with non-GP providers to provide better care, as part of an integrated neighbourhood team.

The cancer-specific elements are detailed in 👉 Part A: Clinical and Support Services (Section 8a).The core requirements include:

• Improving referral practices (with a focus on colorectal, lung and bladder cancer)
• Streamlining diagnosis and referral practice
• Improving early diagnosis by improving screening uptake
• Reducing cancer inequalities

The DES is predominantly unchanged from 2024/25 which provides the opportunity to build on last year’s quality improvement (QI) activity.

Colorectal FIT IFF is incorporated into the DES cancer specification.

CAN-O4: the proportion of patients who have had a lower gastrointestinal urgent suspected cancer referral in the reporting year where at least one urgent suspected cancer referral was accompanied by a faecal immunochemical test result, with the result recorded in the 21 days leading up to the referral.

The FIT IFF threshold is set at 80%. With the lower threshold (payment starts): 65%. Upper threshold (maximum payment): 80%.

Further information can be found here 👉 GI/Colorectal pathway.

Supporting implementation of the DES

DES planning tool 2025/26

We offer a DES planning template and guide for PCNs. We encourage PCNs to use this template for submissions to our early diagnosis team, mid-year and end of year.

For ongoing support contact the team or your designated PCN Facilitator.

👉 PCN DES planning template

👉 PCN DES early diagnosis share and learn recording and presentation

Useful DES quality improvement resources:

Cancer Research UK

👉 PCN DES mini video series

👉 Guide to the Cancer DES Contract

Royal College of General Practitioners

👉 How can your practice undertake quality improvement activity focused on early diagnosis of cancer?

👉 Leading effective and sustainable Quality Improvement within a Primary Care Network: A How To Guide