Figures Show One-in-Three Cancer Pathway Referrals Downgraded

Nearly one-third of referrals made by GPs through the two-week wait cancer pathway were downgraded as less urgent over the previous 12-month period.

This is acccording to a raft of responses pulled from 564 salaried doctors, and acquired by a poll conducted by GPOnline.

Overall, 27% had experienced the bounceback of a referral, or a refusal, in the last year.

Meanwhile, 23% of GPs who had experienced this issue with a referral later discovered that the affected patient was suffering from some form of cancer.

The results showed a slight incline in comparison to the same survey conducted last year.

In response to the figures, GP leaders suggested that restricting access to diagnostics is short-sighted, and could result in severely detrimental outcomes for patients.

It was also discovered that it is common for GPs to be denied direct access to diagnostic cancer tests.

This is particularly worrying, as it had been set out previously by the Independent Cancer Taskforce that all surgery should have access to such scams.

The practice was established as the standard by the NHS Five Year Forward View.

NICE has also asserted that GPs should gain greater access to diagnostics.

It is suggested in support of this policy that such an initiative would result in the NHS being more cost-effective, while diagnosis could also be undertaken more speedily.

Most GPs responding to the survey reported that access to blood tests, chest X-rays and ultrasound diagnostic tests was readily available.

But access to MRI, CT and endoscopy tests can be problematical.

Many respondents indicated that referring to MRI can be based on specific circumstances, while even the body part involved can be taken into consideration at times.

Responding to the survey, GPC clinical and prescribing lead Dr Andrew Green indicated that he is particularly concerned about the results related to the two-week wait pathway.

“The two-week wait pathway should be available for all cases where a GP suspects cancer, and as patients are sometimes inconsiderate enough not to present with text-book symptoms, this service should not be restricted to a limited list of clinical features. Useful work by local cancer leads often demonstrates to practices that they have low two-week wait referral numbers, combined with high conversion rates, showing that they should use the fast-track system more often.”

Green also suggested that diagnostic access is currently inadequate, and that this is disappointing considering that it is so widely advocated.

“Good access to diagnostics has been GPC policy for many years, and is supported by groups such as Cancer Research UK. Unfortunately, many CCGs are reducing what access is available on the grounds of cost-cutting, which is short sighted to say the least, as little is more expensive – or personally devastating – than a late cancer diagnosis. Poor diagnostic access will also increase outpatient referral rates, where the investigations are almost inevitably performed anyway.”


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