GP direct referrals rising for brain and chest cancer scans

The proportion of all brain MRI and chest CT scans that resulted from direct GP referrals has risen over the past two years, but direct referral has flatlined for other diagnostic tests, official data suggests.

MRI scan: GP referrals for brain scans rising (Photo: iStock)
MRI scan: GP referrals for brain scans rising (Photo: iStock)

GPs directly referred patients for 9% of brain MRI scans in 2014/15, statistics from NHS England show, a rise from under 7% two years before in 2012/13 – a 2.6 percentage point rise and proportional increase of 40%.

One in 13 (8%) chest/abdomen CT scans were referred by GPs in 2012/13, while this rose to one in 10 (10%) in 2014/15 – a 17% proportional rise.

But the proportion of kidney or bladder ultrasound tests directly referred for by GPs fell from 31% in 2012/13 to 30% in 2014/15 – equivalent to a 3% drop.

The proportion of chest x-rays and abdomen/pelvis ultrasounds has remained the same over the past three years – with GPs responsible for directly referring patients to 26% of chest x-rays and 46% of abdomen ultrasounds.

Access to diagnostics

As they are often the first medical professional to see patients with potential symptoms of cancer, GPs are supposed to have easy direct access to scans for serious cases.

A GPonline investigation a year ago showed thousands of GPs were being barred from directly referring patients for cancer diagnostic tests by restrictions imposed by CCGs.

Around a quarter of CCGs said they did not commission direct access to non-obstetric ultrasound for ovarian cancer, while a similar number do not commission direct access to chest x-ray for lung cancer.

As many as one half (49%) of CCGs told GPonline they did not commission GP direct access to brain MRI tests.

NHS rationing

And GPs have warned that the situation may be growing worse, with 58% recently reporting that local rationing of services in their area had increased over the preceding year.

GPC deputy chairman Dr Richard Vautrey said: 'Access to CXRs and ultrasound scans have been fairly universal for GPs for many years so it's no surprise that these figures remain the same.

'GP access for more specialised investigations such as MRI and CT have been much more limited but that has been changing with more practices now having direct access, although in some areas this has been restricted with referral restrictions or triage systems. It's important that if GPs are to be able to manage patients in the community and avoid hospital admissions that they have appropriate and timely access to a full range of diagnostic tests.'

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