Primary care guide for the heartburn health check

Introduction to Heartburn Health Check

Greater Manchester Cancer Alliance – part of the NHS – is running a limited number of free heartburn health checks on a first come first served basis for people aged 55-65 who meet certain criteria. The mobile clinic in a van is touring all 10 boroughs in Greater Manchester. We want to work with GP practices and for you to invite those at greatest risk of oesophageal cancer for a check.

What does your GP practice need to do?

We will be asking you to send out a GP text message to eligible patients to invite them to fill in a questionnaire to see if they are suitable for a Heartburn Health Check. Wording and coding for this message can be found further on in the pack.

Why are we running Heartburn Health Checks?

The Heartburn Health Check project aims to identify patients at high risk of Barrett’s Oesophagus to improve early diagnosis of oesophageal cancer.

Barrett’s oesophagus  is a pre-cancerous condition which is caused by chronic gastro-oesophageal reflux. Patients with Barrett’s  have an increased risk of developing oesophageal cancer.

We will offer a capsule sponge test (also known as pill on a string test) to these patients through our Heartburn Health Check initiative. Capsule sponge is a non-endoscopic test that can be delivered in primary care or clinic setting. The test involves the collection of oesophageal cells for cytopathology and immunostaining via a swallowable sponge, contained within a capsule, with an attached thread. The retrieved sponge is sent for laboratory testing to detect Barrett’s  and signs of early cancer/dysplasia.

Patients will be identified through primary care data searches and invited to receive a capsule sponge test. We aim to deliver approximately 450 capsule sponge tests during this pilot. The service is by appointment only.

Patient Population

To be eligible for this pilot, patients must be

• Aged 55 – 65 years old AND
• Have chronic reflux

The primary care data searches have been set up to identify the patients most at risk of developing oesophageal cancer by using a risk stratification score (Kunzmann Score). The patient cohorts are:

55-59 years:

• Group 1 – male, current smoker, any BMI
• Group 2 – male, former smoker, BMI >25
• Group 3 – male, never smoker, BMI >35
• Group 4 – female, current smoker, BMI >35

60-65 years

• Group 1 – Male + Current / Former Smoker + Any BMI
• Group 2 – Male + Never Smoked + BMI 30+
• Group 3 – Female + Current / Former Smoker + BMI 35+

Exclusion criteria: prior diagnosis of Barrett’s, prior oesophageal cancer, OGD within 5 years, cirrhosis, oesophageal varices, known structural abnormality of the oesophagus, displaying symptoms that require an urgent suspected cancer referral, unable to give consent. Where possible, the exclusion criteria have been included in the searches to prevent inviting patients that will not be eligible, however these will be checked prior to the capsule sponge procedure.

Patient Invitations

Once patients have been identified using the data searches, they will be invited to book an appointment at the mobile unit. Practices should send the invitation to people who have been identified in the search. The project team have developed a text invite and a letter invite. Please only send the invitations to patients identified through the data search, as ineligible patients will not be able to book an appointment. The text message and letter invitation include a link or QR for the patients to book their appointments on the mobile unit.

Your GP practice will need to localise the text message for your area by filling in the venue and dates for the mobile clinic before you send out your invitations. Instructions on when to send text invites will be given to each locality around 4 weeks before the van is due in your area.

There are some sites still to be confirmed, and the schedule may change, but all updates will be communicated through the Cancer Alliance PCN Cancer Leads network as well as through the locality management teams in each borough. The latest dates and venues can be found on our website: This Van Can – Heartburn Health Check – Greater Manchester Cancer

If you have any specific questions in relation to this programme of work or have any suggestions about how processes could be improved, please contact gmcancer.earlydiagnosis-primarycare@nhs.net

Frequently asked questions

Your GP practice and reception staff might get questions about the Heartburn Health Checks when they are in your area. Here are some questions and answers about he service.

I’ve had an invite to a Heartburn Health Check/ text message about a Heartburn Health Check – is this genuine, how do I know it’s not a scam?

We can confirm our GP practice is working this the NHS in Greater Manchester who are currently providing a limited number of Heartburn Health Checks in our area based in a mobile clinic. It is safe to follow the link in the text message or call the phone number given in the text message. This will allow you to complete a questionnaire to see if you would benefit from a check-up.

I’ve had a text message and filled in the questionnaire and it says I’m not eligible for the service why not?

Only certain people are suitable for the pill on a string test that they do for the Heartburn Health Check. It will not be suitable for everyone depending on your medical history. If you’ve not qualified for a check, we advise you look at the information you were given when you got the reply. This should include some tips for example on managing acid reflux. If you are still worried, you can book an appointment to see your GP.

I filled in the questionnaire but it says all the appointments for our area are full

There are only currently a limited number of Heartburn Health Checks and so if you get that message it unfortunately means the appointment slot shave all been taken for our area. You’ll be added to a reserve list. If you do not get offered an appointment but are worried about any symptoms, please book an appointment with your GP.

My friend/partner/ neighbour has had a text message/invite for a Heartburn Health Check can I have one?

The heartburn health checks are being run by Greater Manchester Cancer Alliance not our surgery. You need to meet a certain criteria that would mean you are at a greater risk of developing oesophageal cancer in the future t qualify for a test. If you have not had a text message/invite, it means you do not meet the current criteria but if you do have any symptoms which you are worried about then you can book an appointment with your GP.

What’s that van parked in (local) location doing?

The NHS in Greater Manchester is currently offering some heartburn health checks to certain patients. You’ll be sent a text message invite if you are eligible.