{"entity":{"id":"idea-acc-primary-care-shared-care-agreements","kind":"idea","name":"Formal shared-care agreements between oncology and family doctors, with same-day e-consult","aka":[],"tldr":"Family doctors often do not know who is responsible for a cancer patient's blood pressure, diabetes or new symptom. Written agreements plus a same-day electronic question line to the oncologist would fill the gap.","summary":"During active treatment, primary care is often sidelined; after treatment, oncology withdraws and primary care is unclear about what to monitor. Formal shared-care agreements defining who manages what, combined with electronic consultation channels with a same-day response target, have improved coordination in other chronic diseases. Applying them systematically in oncology would reduce emergency visits and duplicated or missed care.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Fragmented care and guideline gaps): Hanna et al., Mortality due to cancer treatment delay: systematic review and meta-analysis (BMJ 2020)","url":"https://doi.org/10.1136/bmj.m4087"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-care-fragmentation","b-aging-comorbidity"],"keyPapers":["paper-hanna-bmj"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Practices under shared-care agreements with e-consult access will reduce unplanned emergency attendances of their cancer patients by at least 15% and increase management of comorbidities to target.","rationale":"Ambiguity of responsibility is a documented cause of missed care in cancer; explicit agreements resolve it at low cost.","test":"A cluster-randomised trial across 60 primary care practices with emergency attendance, comorbidity control, and clinician satisfaction as endpoints.","maturity":"early-clinical","actor":"clinic","cost":"small","horizonYears":2},"route":"/ideas/idea-acc-primary-care-shared-care-agreements/","neighbours":{"bottleneck":[{"id":"b-care-fragmentation","kind":"bottleneck","name":"Fragmented care and guideline gaps","route":"/bottlenecks/b-care-fragmentation/"},{"id":"b-aging-comorbidity","kind":"bottleneck","name":"Older and multimorbid patients are excluded and undertreated","route":"/bottlenecks/b-aging-comorbidity/"}],"paper":[{"id":"paper-hanna-bmj","kind":"paper","name":"Mortality due to cancer treatment delay: systematic review and meta-analysis","route":"/key-papers/paper-hanna-bmj/"}]}}