Bring back 'GP for life' to cut cancer delays, say experts

Better continuity of care and longer consultation times in general practice could reduce delays to cancer diagnosis, experts have said.

Loss of continuity of care has damaged GPs' ability to spot cancer symptoms, experts said

Allowing patients to see the same doctor and build a relationship over time could help GPs spot signs of cancer that might otherwise be missed, their review said.

Primary care experts writing in the Journal of the Royal Society of Medicine said longer consultation times may encourage patients to report symptoms more often.

But this would be difficult to introduce due to the recent NHS reorganisation and pressure on limited resources, they said.

The UK has a poor record on cancer diagnosis. Over 10,000 deaths a year could be prevented if survival rates matched the best in Europe.

Late diagnosis is a significant factor and research shows 24% of cancers are diagnosed through emergency admission.

A panel of experts led by Dr Thomas Round, clinical research fellow at King’s College London, said primary care had 'fragmented' in recent years with the loss of partners and a rise in sessional work.

While many GPs develop a 'gut feeling' about patients they've known for a long time that can prompt further investigation of symptoms, this may have been lost as the amount of sessional care increases.

Fragmentation may also have made communicating with GPs about education and the latest diagnostic aids more difficult.

Experts said patients should see only a small number of GPs to restore the long-term relationship between doctor and patient. Longer consultations would allow GPs to address the patients' agenda rather than focusing on QOF, they said.

Better dissemination of information to GPs, greater use of cancer risk assessment tools and giving patients access to records could also help to detect cancers earlier.

Dr Round said: 'Early diagnosis is the result of the best interaction between patients and their GPs. Some of the interventions we are suggesting, such as longer GP consultation times, have been advocated by the RCGP, and could be implemented at an individual GP and practice level.

'However, they would be difficult to implement given recent NHS reorganisation and constrained budgets, with primary care dealing with 90% of NHS patient encounters with less than 9% of the NHS budget.'

He added: 'If patients can access all the information about themselves, make appointments, order repeat prescriptions and access information and decision making tools, this could increase health literacy, improve concordance and accuracy in the records as well as a trusting adult-to-adult relationship that itself improves health and outcomes.'

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