Ban on GP access to hospital tests hampering early diagnosis, GPs warn

The lack of GP direct access to hospital-based diagnostic tests is blocking early detection of diseases, causing frustration among GPs and anxiety in patients, GPs have warned.

Dr Rose: Barriers to GP scan access causing 'frustration and dismay' (Photo: Pete Hill)
Dr Rose: Barriers to GP scan access causing 'frustration and dismay' (Photo: Pete Hill)

GPs should be trusted to investigate symptoms using a range of specialist investigations currently reserved only for consultant access, according to LMCs.

Representatives attending the annual LMC conference in York last week voted in favour of a motion that said the lack of GP open access to certain hospital-based investigations was 'hampering identification of serious illness in patients at an early stage'.

Dr Shamin Rose from Liverpool LMC said many GPs had specialist knowledge of disciplines such as surgery, orthopaedics and gastroenterology. 'GPs can and should be trusted to use their individual expert knowledge in order to determine appropriate investigations prior to referral for definitive treatments,' she said.

'Bearing in mind there is much guidance in the way of clinical pathways determined locally and guidance from expert bodies nationally and internationally. It is not appropriate that certain investigations should only be available to hospital consultants.'

GPs are routinely denied access to mammography, certain MRI scans, neonatal hip ultrasound scans and abdominal ultrasound for projectile vomiting in infants, Dr Rose said.

'Frustration and dismay'

Two hospitals in the same area may have different policies on what local GPs can directly access, she added.

'There is frustration and dismay among GPs, there is anxiety among patients when there are indications for investigation but barriers to them being requested by GPs.'

She concluded that GPs 'should be granted access to a wider range of outpatient investigations'.

Dr Penelope Jarrett from Lambeth LMC said she felt 'uncomfortable' about the motion. 'I have no specialist training, I was only trained as a GP. I do not feel confident in interpreting many of these scan results. Even if I did, because clinical context is often so important, I would still lack expertise.'

But Dr Andrew Green, chairman of the GPC’s clinical and prescribing subcommittee, said: 'GPs have an enormous wealth of experience and sometimes within the same practice as well. Nobody here is talking about acting outside our competence. GPs are experts at working out what they're good at and what they're not good at, and what we can do and what we can't.'

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