Picking the Right Places: Recruiting GPs by Regional Performance
Why are women in some parts of England diagnosed with ovarian cancer earlier than others?
To explore that question, the study had to compare contrasting areas. Clinical Commissioning Groups (CCGs) were ranked by the share of ovarian cancer diagnoses made at stages 1 and 2, with one-year survival as a secondary measure. Two higher-performing and three lower-performing areas were selected.
Stage one was 24 in-depth interviews with GPs and CCG cancer service leads across those five areas. GPs were contacted through the CCGs and through an online UK doctor community. Interviews lasted 40 to 80 minutes, mostly in person, with some moved to video and delayed because of COVID-19. The GPs were a mix of partners, salaried GPs and locums, split evenly between men and women.
Stage two reviewed CCG governing board minutes going back several years to see whether ovarian cancer had featured on management agendas.
Stage three placed four questions in an omnibus survey of 1,000 GPs with regional quotas across the UK. This allowed testing and referral patterns in the 20 highest- and 20 lowest-performing CCGs to be compared with the national picture.
The design accepted a known challenge: ovarian cancer is relatively rare, so many GPs see few cases. Pairing a small, carefully targeted qualitative sample with a large quantitative one gave both depth and a check on scale.
