Pennine GP Alliance (PGPA) is celebrating the success of its Cancer Innovation Project, which has significantly improved cancer outcomes across Calderdale and created a strong foundation for future work.
Running from April 2024 to December 2025, the project introduced a dedicated Cancer Care Coordinator role to strengthen collaboration, improve early detection, and reduce health inequalities. As the project concludes, it leaves behind measurable clinical impact, stronger partnerships, and a lasting legacy that will continue to benefit patients and services.
One of the project’s most significant achievements has been the shift from a fragmented, siloed approach to a coordinated, multi-agency model. By bringing together primary care, secondary care, community organisations, and voluntary sector partners, PGPA has helped create a more joined-up system focused on patient outcomes. This collaborative approach has improved communication, streamlined referral pathways, and ensured patients receive more timely and appropriate care.
A key success of the project has been its contribution to reversing the decline in cancer screening uptake in Calderdale following the COVID-19 pandemic.
Since April 2024:
- Bowel screening increased from 48.3% to 64.1% – equating to over 10,400 additional people screened
- Cervical screening rose from 67.6% to 72.5% – over 2,000 more people screened
- Breast screening improved, with current performance exceeding pre-pandemic levels in active areas – around 450 additional people screened
In total, approximately 12,850 more people have accessed life-saving cancer screening, supporting earlier diagnosis and improving survival outcomes.
Alongside this, the project has driven meaningful improvements in how patients move through cancer pathways.
- FIT (Faecal Immunochemical Test) compliance increased from under 60% to 77%, helping ensure patients are referred appropriately and seen more quickly.
- DNA (Did Not Attend) rates have reduced through the introduction of automated SMS reminders, improving attendance at urgent suspected cancer appointments.
- A simple, patient-friendly “How to do your FIT test” video, viewed more than 2,200 times, has also helped reduce failed tests and avoid unnecessary delays.
Together, these changes have made cancer pathways more efficient and improved the overall patient experience.
A strong focus throughout the project has been tackling inequalities in cancer care by working directly with underserved communities. This has included co-producing tailored resources for people living with serious mental illness (SMI), such as the videos “A Right to Live” and “Bits, Boobs and Poo”, designed to break down stigma and improve understanding of cancer screening. Outreach has also been delivered in partnership with organisations supporting people experiencing homelessness, addiction, and learning disabilities, helping to ensure that key messages reach those who may face additional barriers to accessing care. In areas such as North Halifax and the HX3 postcode, where late-stage diagnoses have historically been higher, targeted interventions have helped raise awareness and improve access. Collectively, this work has helped normalise conversations around cancer and reduce barriers to screening in communities that are often underrepresented.
Education and workforce development have also been central to the project’s success. A wide programme of training has supported GP practices, personalised care teams, and community organisations to build confidence in cancer awareness, screening promotion, and patient support. The development of a Cancer Care Review (CCR) toolkit has enabled a more holistic and consistent approach to patient care, while ongoing support for cancer engagement and awareness teams working in local communities has strengthened capability across the system. Feedback from partners highlights increased confidence, improved skills, and stronger engagement across the workforce as a direct result of this work.
A key learning from the project has been the importance of the Cancer Care Coordinator role as a ‘human connector’ between services. By representing primary care within secondary care forums, and ensuring communication flows effectively in both directions, the role has helped improve referral quality, enable faster problem-solving, and strengthen relationships across the system. Partners have described the role as “part of the team” and recognised its significant contribution to driving system-wide improvements.
The success of the project has led to the role being made permanent, evolving into a Primary Care Cancer and Palliative Care Improvement Lead. This ensures that the momentum built over the past 18 months will continue, with a clear focus on sustaining and building on the progress achieved.
The project leaves behind a strong and practical legacy, including new digital tools to monitor screening uptake and identify gaps, improved referral processes and clinical system protocols, and a well-established network of multi-agency partnerships. A suite of educational resources and patient engagement materials will continue to support both staff and communities, alongside ongoing “Connecting Roles” events designed to sustain collaboration and shared learning.
Building on this foundation, PGPA will continue to develop cancer and palliative care support services, with a focus on strengthening engagement with all practices, expanding collaborative workstreams, enhancing evaluation and data-driven improvement, and continuing to reduce inequalities while improving patient outcomes.
While the achievements of the Cancer Innovation Project are significant, they reflect the collective efforts of partners across Calderdale. From healthcare professionals to community organisations, this has been a truly collaborative success, demonstrating what can be achieved through partnership working, innovation, and a shared commitment to improving care for local people.
Will Menzies, CEO Pennine GP Alliance said:
“This project shows what’s possible when we work together with a clear, shared purpose. By connecting services and focusing on early detection and equity, we’ve made real progress for patients in Calderdale – and, importantly, built something that will continue to deliver into the future.”
Find out more about the work led by the Cancer Care Coordinator here.