Safety Netting

Safety Netting (SN)

Robust safety netting should reflect three core elements:

  • Patient Communication
  • GP Actions During Consultation
  • Practice Processes and Systems

Implementing practice safety netting procedures in primary care.

Safety netting is an important part of cancer referrals and investigations.

Review Safety Netting Practices – Primary Care Networks should support practices to review their safety netting processes. Could Primary Care Networks agree some standard processes and principles across the Primary Care Network?  Support update and learning sessions including – using  safety netting review tools .Your CRUK Facilitator can provide safety netting workshops/sessions and resources.Download Cancer Research UK Cancer Insights Safety Netting

Ensure recently issued Northern Cancer Alliance COVID-19 Safety Netting Guidance has been used to consider current practice and potential enhancements. N.B. New Safety Netting Guidance and Tools were issued by the Cancer Alliance in March 2020.

Consider the use of safety netting templates within clinical systems.

When practices audit their cancer diagnoses it can often show occasions where there are delays in investigation and referral for a variety of reasons. These delays can be related to patients, clinical or system failure.  Safety netting can minimise this risk

Safety Netting – Hints and Tips

Listed below are some helpful sources of information and tools to support effective patient safety netting:

  1. A basic spreadsheet to support an effective safety net system of follow up to discuss investigation/potential referrals available here.
  2. EMIS 5 Tips – creating deferred treatment workflow available here.
  3. Systemone – CDRC Delayed Treatment System Guide available here.
  4. CRUK Safety netting patients during theCOVID-19 pandemic available here.
  5. NCA advice to GPs for suspected cancer referrals during COVID-19 Pandemic here.

Safety Netting in General Practice

Safety netting in a general practice is way of ensuring that systems are in place to provide safe monitoring and follow-up for patients. It can help to reduce clinical risk, manage diagnostic uncertainty and support timely diagnosis of cancer.

The short film below provides an overview of the benefits of safety netting to the patient and the primary care team.

For the PCN Early Cancer Diagnosis DES – consider a minimal standard including:

Safety Netting

  1. System to ensure that patients referred under 2WW referrals are seen by secondary care and if not are contacted by the practice and appropriate actions taken.
  2. System to ensure any patient who needs a deferred 2WW referral (for Covid or other reason) are referred at the appropriate time.
  3. System to ensure that patients referred for diagnostic radiology to exclude cancer  ( such as CT for pancreatic cancer or vague symptoms, repeat CXR or US ovaries for a patient with raised CA125) have the investigation in a timely manner and if not are followed up by the practice.
  4. Systems are in place to support locums – who safety nets their referrals and investigations for suspected cancer?
  5. Systems are in place to cover (both expected and unexpected) ill health in the clinical team (doctors and nurse practitioners) to ensure that patients with suspected cancer are followed up appropriately.