Decommissioning of C the Signs

Dear Colleagues,

Following the evaluation of the C the Signs (CTS) pilot, the decision has been made to not commission the tool by the clinical leads and Cancer Boards and therefore C the Signs will no longer be funded centrally. The contract will come to an end on 31 August 2022.  The decision is based on the following rationale: 

  • Inconclusive evidence that CTS leads to improved early diagnosis of cancer, though the tool has useful functionality
  • Variation in uptake and usage across GP Practices
  • Value for money 

The North East London ICS digital programme is currently standardising digital tools across all primary care GP practices to allow all practices to have access to the same tools. They are reviewing current options and are supporting the evaluation of modules from Ardens and CEG, amongst others, that are currently possible to scale up to all practices to support the PCN DES requirements. 

We appreciate that you may be concerned about losing C the Signs, and may consider funding this yourself but before you commit, we would like to make you aware of that as North East London moves away from C the signs there will be no dedicated administrative and IT support ensuring that the system remains up to date with the latest local referral forms and local pathways such as direct access diagnostics (TCST will continue to ensure pan London forms are accessible). 

If you would like to discuss this further, please contact your local GP Cancer Clinical Lead.

Newham GP Cancer Lead                                         Dr Helen Stedeford –

Waltham Forest GP Cancer Lead                            Dr Shaz Kang –  

Barking and Dagenham GP Cancer Lead               Dr Kanika Rai -

Havering GP Cancer Lead                                         Dr Maurice Sanomi -

Redbridge GP Cancer Lead                                       Dr Jyoti Sood - 

In place of C the Signs please see below a range of cancer support tools for managing cancer referrals: 

  • Direct Access Pathways
  • GP Matrix - Local direct access diagnostics pathways
  • For EMIS practices, there are EMIS Direct Access Recall Templates 

C the Signs will contact you in due course to discuss the exit plan and we look forward to supporting practices during this process.

Kind Regards

Kay Saini
Head of Long Term Conditions
NHS North East London Clinical Commissioning Group
TNW Integrated Care Partnerships and
North East London Health and Care Partnership
020 3688 2653 / 07852 918 714

4th Floor, Unex Tower,
5 Station Street, Stratford, E15 1DA


Jeremy Kidd
Deputy Director of Transformation - Planned Care
NHS North East London Clinical Commissioning Group
Barking and Dagenham, Havering and Redbridge (BHR) Integrated Care Partnership and North East London Health
and Care Partnership
020 3182 3049 / 0750 055 3783

6th Floor, North House,
St. Edward’s Way, Romford, RM1 3AE