Cancer referral system needs overhaul to help GPs boost early diagnosis

The NHS cancer referral system must be reformed to help GPs bring UK rates of early diagnosis and survival in line with other countries, the RCGP has warned.

Dr Maureen Baker: cancer referral warning (Photo: Pete Hill)
Dr Maureen Baker: cancer referral warning (Photo: Pete Hill)

GPs are too often criticised for ‘inappropriate’ referrals, the Discovery Programme conference on the diagnosis of symptomatic cancer heard on Tuesday.

‘There are significant questions about the capability of the NHS to deal with referrals,’ said RCGP chairwoman Dr Maureen Baker.

‘The system needs to be reworked to allow symptom referral pathways so the system isn’t overloaded. As GPs, we need to have confidence that the system can effectively handle the referrals that we make.’

GP cancer referral

Sara Hiom, director of information at Cancer Research UK, said: ‘No self-respecting GP will refer patients if they don’t think the system is there.’

‘There is a fundamental lack of access to tests in primary care, and future need is going to be even greater.'

Primary care doctors get ‘a lot of the blame for problems with early diagnosis’ despite GPs seeing cancer cases so rarely, she added.

Dr Baker said that GPs are left with few options when specialist tests are denied to them.

‘If someone’s symptoms are vague and don’t fit a characteristic disease profile, the referral may get bounced back. And the majority of patients with cancer do not have ‘red flags’ that fit nicely into the two-week referral pathway process.’

GP diagnostic access

Dr Baker said that distinguishing cancer from other serious diseases such as MS from vague symptoms was a ‘balancing act’, and more support from specialists was needed.

‘GP access to diagnostics is so variable. What would help us is better access to real-time advice from specialists,’ she said.

‘Given the funding and resource pressures we face, GPs have done well with the access available, but we recognise that we don’t do as well in cancer outcomes in this country, it needs to improve, and we need to play our part in that.’

Ms Hiom said that Cancer Research UK has recommended to the new NHS cancer taskforce that GPs need better access to tests. NHS England’s five-year cancer strategy is expected to be published this summer.

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