Medefer working in partnership with Surrey & Sussex Cancer Alliance on prevention, early diagnosis and digital-first care. 

Prostate cancer remains the most common cancer in men in the UK, yet many cases are detected too late because testing is often opportunistic and inconsistent. During the Covid-19 pandemic, thousands of men missed their chance for timely diagnosis. In Surrey and Sussex alone, the Cancer Alliance estimated a shortfall of over 3,000 suspected cancer referrals, including around 470 prostate cancer diagnoses.

To address this, the Targeted Prostate Health Check (TPHC) was launched, a consultant-led, nurse-delivered, community-based pathway designed to detect disease earlier, reduce inequality and avoid adding pressure to general practice.

“We needed a simple, targeted way to bring men back in without piling work onto practices.” – GP, Surrey

The challenge: Early detection without overloading primary care

The NHS Long Term Plan calls for a shift toward prevention and earlier intervention, supported by a digital-first approach that reduces GP’s workload.

The TPHC programme was built precisely for this purpose: to identify higher-risk men, engage them proactively and direct only those who truly needed diagnostics into the specialist system without burdening GPs.

Its aims were clear:

Detect clinically significant cancers earlier and more equitably
Provide an end-to-end pathway managed digitally from invitation to referral
Protect GP time by handling results and follow-up outside the practice
Create a replicable, scalable, data-led model.

The approach: Consultant-led, nurse-delivered, digital-first care

Working with local primary care networks (PCNs) and GP federations, the service provided convenient community phlebotomy clinics so that men could attend locally.

Using GP records, eligible men were identified and invited via text message or letter to visit a dedicated prostate health website, where they could read clear information and give consent digitally. A helpline was also available, allowing men to complete the process entirely by phone, if preferred.

Testing and coordination were managed through Medefer’s digital platform, which underpinned the pathway using its PreDoc specialist questionnaires, automated data handling and referral tools.

Pathway summary

Invitation and consent: Men invited by text or letter to learn more and consent online or by phone.
Community testing: Phlebotomy and urine dipstick clinics provided locally through PCNs and federations.
Results handling:
- Normal results: automatically discharged with an agreed letter including safety-netting and retesting advice.
- Elevated results: triggered a booked call with a Clinical Nurse Specialist (CNS) to discuss findings, review medical history, and offer counselling.
Specialist referral: If indicated, Medefer consultants completed urgent suspected cancer (2WW) referrals through the NHS eRS system using locally agreed templates.

This ensured a fully digital, end-to-end pathway from invitation through to referral, without administrative burden on general practice.

“It was simple, reassuring and local. I probably wouldn’t have asked my GP otherwise. This made it easy to take that step.” – Patient, TPHC

Most cancers were organ-confined (T2: 67%) and clinically significant (ISUP 2–5) clear evidence of earlier, meaningful detection.

Independent evaluation found the programme, “well received by both patients and clinicians” and that it “represents value-for-money for healthcare systems.”

Activation and awareness: Empowering men to act

The TPHC programme not only detected cancers earlier, but it also activated men to take control of their health.

83% of participants reported a better understanding of prostate cancer and early detection after taking part, up from a baseline of 74%. Many participants said the experience encouraged them to share information with friends and family.

“I didn’t realise prostate cancer could develop with no symptoms. The information made me take the test and talk to my friends about doing the same.” – Participant feedback

These findings show the pathway’s dual value: detecting disease while improving population awareness and self-management, a core objective of prevention-first care.

Reducing GP workload and improving system efficiency

By managing invitations, testing and results digitally, the TPHC model removed administrative loops from general practice.

GPs did not need to book, interpret or communicate test results
CNSs managed all patient discussions and follow-up
Consultant urologists directly authorised 2WW referrals.

This structure increased 2WW efficiency (30% conversion rate) and kept diagnostic capacity focused where it added most value.

Economic evaluation: Strong value-for-money evidence

Independent cost-utility analysis by Unity Insights (commissioned by Medefer and KSS Health Innovation Network) confirmed that the service delivers substantial system value:

Incremental cost: £25.54 per person tested.
Incremental QALY gain: 0.00671.
ICER: £3,709 per QALY (base case), £3,102 with economies of scale.
Cost-effectiveness: >99% probability at £20k/QALY NICE threshold.

This equates to approximately 459 additional QALYs across the invited cohort, making it comparable in value to established national screening programmes.

Evaluators concluded: “Policymakers should consider adopting the TPHC programme on a greater scale to improve patient outcomes.”

Spread and sustainability: A blueprint for prevention-first men’s health

To support replication, the project produced a comprehensive toolkit for commissioners and Cancer Alliances, including data specifications, SOPs, referral templates, patient materials and live dashboards.

The approach and outcomes have been shared at national level, including the All-Party Parliamentary Group on Prostate Cancer Screening and events in both the House of Commons and House of Lords (2025), influencing wider NHS screening policy.

Strategic takeaway

The Targeted Prostate Health Check demonstrates how consultant-led, nurse-delivered, digitally supported care can transform population health.

By combining proactive outreach, community-based testing and a seamless digital infrastructure through Medefer’s platform, the pathway delivers:

Earlier, clinically meaningful detection
Improved awareness and engagement
Reduced GP workload
Proven cost-effectiveness and scalability.

It is a replicable national model for men’s health, embodying the NHS’s shift toward preventative, data-driven and digitally enabled care that improves outcomes and reduces inequalities.