GPs in England to send suspected cancer patients directly for tests

Scheme starting this month is aimed at improving Britain’s poor record on early diagnosis

All GPs in England will be able to refer suspected cancer patients for tests without them first having to see a specialist under an NHS initiative designed to speed up diagnosis.

The scheme, which starts this month, will let family doctors send patients with potential symptoms straight to have a scan, X-ray or other diagnostic test.

“Tens of thousands” of cases of cancer could be detected earlier as a result of the new approach, which is intended to help improve Britain’s poor record on early diagnosis.

It is aimed at ensuring that the 67,000 people a year who have possible but vague signs of the disease – such as a cough, fatigue or dizziness – and are classed as non-urgent for testing purposes, no longer face long delays before getting tested.

GPs and practice nurses will now be able to order these checks directly, in a move that NHS England bosses hope will cut average wait times by about two-thirds, to four weeks, so that the patient gets their result much faster.

Amanda Pritchard, the organisation’s chief executive, will announce the expansion of fast-track testing in a speech on Wednesday to a gathering of health service leaders at the annual conference of hospitals body NHS Providers in Liverpool.

“By sending patients straight to testing, we can catch and treat more cancers at an earlier stage, helping us to deliver on our NHS long term plan’s ambitions to diagnose three-quarters of cancers at stages one or two when they are easier to treat,” she will say.

In future every GP will be able to refer patients to have an ultrasound, MRI, X-ray or a procedure called sigmoidoscopy – to detect colon and rectal cancers – at either a hospital or one of the community diagnostic centres that NHS England is setting up. Currently only some surgeries are able to do that.

They will use existing NHS software systems to make referrals for patients, who under National Institute for Health and Care Excellence (Nice) guidance are seen as less of a priority than those with more worrying signs of cancer such as a lump or bleeding.

Cancer Research UK and GP leaders welcomed the change.

Kruti Shrotri, Cancer Research UK’s head of policy, said: “Cancer that is diagnosed and treated at an early stage is more likely to be treated successfully, so we welcome this announcement by NHSE which will help speed up diagnosis for patients.”

Prof Martin Marshall, chair of the Royal College of GPs, said family doctors were already doing a good job at referring people with cancer symptoms to see a specialist within two weeks, and were doing that with 20% more patients than before Covid hit in spring 2020.

“However, there will be patients who might not meet the criteria for rapid referral and have vague symptoms that could be cancer but are more likely to be less serious common conditions. In these situations, direct access to diagnostic services can be helpful,” he said.

“GPs want to ensure timely diagnosis for their patients, so that those with cancer can receive the appropriate treatment, and those without can be reassured.”

The change is “a positive step”, which responds to GPs’ longstanding request to have the right to refer more patients, Marshall added.

It remains to be seen how the NHS testing system, which is already under intense pressure, will cope with the change. NHS England said the community diagnostic centres – dozens are open and in all 160 planned – will play a key role. They should be able to deliver 9m checks a year for a range of conditions by the end of 2024 once they are all up and running, it said.

But in recent years growing numbers of patients have had to wait a long time to undergo a test or get a result back because demand, partly caused by GPs referring more people for cancer checks, has outstripped the NHS’s ability to meet it. For example, at the end of September about 320,000 patients in England were waiting more than six weeks – the supposed maximum – for a key diagnostic test. That was 11 times higher than the 30,200 who were in the same position in September 2019.

The NHS has been unable to meet key waiting times targets for diagnostic tests for some time. For instance, only 72.6% of people referred for an urgent appointment because they have suspected cancer are being seen within two weeks, though the target is 93%.


Denis Campbell Health policy editor

The GuardianTramp

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