title: Developing cancer services strategy in primary care in England: primary care trust managers' views of the primary care cancer leads initiative.
abstract: OBJECTIVE
  Primary care cancer lead clinicians (PCCLs) act strategically in primary care trusts (PCTs) in England to improve communication and understanding of cancer across primary and secondary care and provide a link between Cancer Networks and primary care. The aim is to evaluate the first three years of the initiative.
  
  
  METHODS
  A postal questionnaire was sent to all PCT chief executives in all PCTs in England and some were passed on to other PCT managers for completion. The response rate was 61 per cent. PCT directors of public health were the largest group of respondents (29 per cent). Most (74 per cent) PCCLs were GPs and 22 per cent were nurses.
  
  
  RESULTS
  PCCLs were most likely to focus on palliative care and preventive services. Key achievements were identified as raising awareness of cancer, developing relationships and promoting primary care. The personal skills of the PCCLs were important as was support of colleagues at all levels. Lack of time was a major barrier to achievement, as was a lack of understanding of the role from others. Links with the Cancer Networks were being developed. About 85 per cent of managers wanted the role to continue.
  
  
  CONCLUSIONS
  The paper illustrates that PCCLs are at the forefront of improving cancer services in primary care. They are particularly important in view of the priority of reducing premature deaths and promotion of healthy lifestyles.
authors.affiliation: Centre for Research in Primary Care, University of Leeds, Leeds, UK. b.leese@leeds.ac.uk
authors.forename: Brenda
authors.initials: B
authors.lastname: Leese
authors.forename: Phil
authors.initials: P
authors.lastname: Heywood
authors.forename: Victoria
authors.initials: V
authors.lastname: Allgar
authors.forename: Reg
authors.initials: R
authors.lastname: Walker
authors.forename: Aamra
authors.initials: A
authors.lastname: Darr
authors.forename: Ikhlaq
authors.initials: I
authors.lastname: Din
mesh_terms: D001291:Attitude of Health Personnel; D002173:Cancer Care Facilities / Q000458:organization & administration*; D003299:Cooperative Behavior; D004739:England; D006801:Humans; D007857:Leadership; D009369:Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D010166:Palliative Care; D008486:Physician Executives; D010819:Physician's Role; D010821:Physicians, Family / Q000523:psychology; D011320:Primary Health Care / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D012041:Regional Medical Programs / Q000458:organization & administration*; D013222:State Medicine; D011795:Surveys and Questionnaires