COMPASS
The Community Pharmacy Assessment for Barrett’s Oesophagus and Reflux Symptoms (COMPASS) is a 12-month pilot. It aims to improve early diagnosis rates of oesophageal cancer by offering capsule sponge endoscopy to patients identified in pharmacy and community settings. North Central London is collaborating with Cyted Health, Boots, community pharmacies, Barnet, Haringey and Islington GP Federations and secondary care.
The project is funded by NHS England and SBRI Healthcare and is also being delivered in the East Midlands Cancer Alliance area.
What is oesophageal cancer?
- Oesophageal cancer is a cancer that’s found anywhere in the oesophagus, sometimes called the gullet or food pipe.
- The oesophagus connects your mouth to your stomach.
- How serious oesophageal cancer is depends on where it is in the oesophagus, how big the tumour is, if it has spread and your general health.
Why is this pilot important?
- Oesophageal cancer is typically diagnosed at late stage when treatment outcomes are worse.
- Early diagnosis oesophageal cancer (% diagnosed at stages 1-2) 2025/2026:
– National 20.3%
– North Central London 21.2%
(Source: National CancerStats2 RCRD Extract) - People with chronic gastro-oesophageal reflux disease (GORD), are at higher risk of experiencing cell changes in the food pipe that can lead to cancer and precancerous conditions
- A significant proportion of people with GORD are not telling their GP about their symptoms. Instead, they are going to community pharmacies for over-the-counter heartburn medication.
What is the capsule sponge procedure?
- Patients are asked to swallow a multivitamin-sized capsule attached to a thread
- It is left in stomach for the sponge capsule coating to dissolve
- The sponge is gently pulled out via a thread.
- As it travels back up, it collects cell samples from the lining of the oesophagus
- The sample collected on the sponge is analysed to determine if further testing is needed.
COMPASS pathway summary
Participating pharmacies
Key information for GP practices
The input required from GP practices is on an admin basis only. In the pilot areas of Barnet, Haringey and Islington, the GP Federation will upload result letters and share to be saved to the patient’s records.
All onward referral and discussion with the patient will be undertaken by dedicated Federation GPs
The GP Federation will be uploading the results and letters to EMIS and notifying GP practices.
Not currently. Separately to this project we are exploring the possibility of a direct GP referral pathway for capsule sponge for patients with persistent reflux / GORD.
No. We are trying to capture a subset of patients who are purchasing over the counter medication that have not sought advice from their GP or had previous investigations for their symptoms. This is so that we can evaluate the potential role of community pharmacies in early identification of patients with OG pathology.
The testing organisation i.e. the Finchley Memorial Community Diagnostic Centre or Boots.
The GP Federation.
Please look at the information at https://www.endosign.com/hcp/clinical-evidence
Yes. Please click below for an example: