Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul;12(3):e002354.
doi: 10.1136/bmjoq-2023-002354.

Using an electronic safety netting tool designed to improve safety with respect to cancer referral in primary care: a qualitative service evaluation using rapid appraisal methods

Georgia B Black  1   2 , Samantha Machen  2 , Saira Parker-Deeks  3 , Andrea Cronin  3 , Donna Chung  4
Affiliations

Using an electronic safety netting tool designed to improve safety with respect to cancer referral in primary care: a qualitative service evaluation using rapid appraisal methods

Georgia B Black et al. BMJ Open Qual. 2023 Jul.

Abstract

Background: This evaluation assesses the impact of an electronic safety netting software (E-SN) package, C the Signs, in primary care services across five boroughs in North East London (NEL).

Aim: This study evaluates the use of E-SN software in primary care, examining its benefits and barriers, safety implications, and overall impact on individual and practice usage.

Design and setting: The study is based on semi-structured interviews with 21 clinical and non-clinical members of staff from all primary care services using the software in NEL.

Method: Semi-structured interviews were conducted to gather data on individual use of the software, safety implications and practice use of features such as the monitoring dashboard. Data were analysed using a rapid qualitative methodology.

Results: Two approaches to E-SN software adoption were reported: whole practice adoption and self-directed use. Practices benefitted from shared responsibility for safety netting and using software to track patients' progress in secondary care. Adoption was affected by information technology and administrative resources. Decision-support tools were used infrequently due to a lack of appreciation for their benefits. Selective adoption of different E-SN functions restricted its potential impact on early diagnosis.

Conclusion: The use of E-SN software in primary care services in NEL varied among participants. While some found it to be beneficial, others were sceptical of its impact on clinical decision-making. Nonetheless, the software was found to be effective in managing referral processes and tracking patients' progress in other points of care.

Keywords: CANCER; Decision support, computerised; Electronic Health Records; Patient safety; Qualitative research.

PubMed Disclaimer

Conflict of interest statement

Competing interests: DC works in the Cancer Alliance where this evaluation took place. AC and SP-D worked in the NEL Commissioning Support Unit at the time this evaluation was undertaken. The results of the evaluation had a direct impact on ongoing funding decisions in relation to the software.

References

    1. Friedemann Smith C, Lunn H, Wong G, et al. “Optimising GPs’ communication of advice to facilitate patients' self-care and prompt follow-up when the diagnosis is uncertain: a realist review of “safety-netting” in primary care”. BMJ Qual Saf 2022;31:541–54. 10.1136/bmjqs-2021-014529 - DOI - PMC - PubMed
    1. Jones D, Dunn L, Watt I, et al. Safety netting for primary care: evidence from a literature review. Br J Gen Pract 2019;69:e70–9. 10.3399/bjgp18X700193 - DOI - PMC - PubMed
    1. 2020 surveillance of suspected cancer: recognition and referral (NICE guideline NG12). London: National Institute for Health and Care Excellence (UK); 2020. - PubMed
    1. NHS England . Achieving world-class cancer outcomes: a strategy for England 2015-2020; 2015.
    1. Edwards PJ, Bennett-Britton I, Ridd MJ, et al. Factors affecting the documentation of spoken safety-netting advice in routine GP consultations: a cross-sectional study. Br J Gen Pract 2021;71:e869–76. 10.3399/BJGP.2021.0195 - DOI - PMC - PubMed

Publication types