Editorial: Cost-cutting at the price of a life is no saving

Early diagnosis of cancer is crucial if the UK is to improve survival rates.

As part of England's cancer strategy, GPs should be able to directly refer patients for scans such as MRI and flexible sigmoidoscopy to help increase early diagnosis.

However, as GP reveals this week, many PCTs are in fact restricting access to these scans. Our investigation shows some PCTs are considering imposing limits on the number of referrals GPs can make, while others have scrapped direct GP access to the scans. Access across the country is patchy.

As Cancer Research UK points out, it is reasonable for PCTs to review referral patterns and monitor costs. But setting limits on referrals, or barring direct access, may delay diagnosis, which potentially puts lives at risk. These restrictions are also a false economy. While the plans may deliver instant cost savings on one line of the budget, they are likely to drive up spend elsewhere.

RCGP imaging lead, Dr Nick Summerton says difficulty accessing scans in some areas means GPs are often forced to use the two-week urgent referral pathway as there is no other way for patients to have symptoms investigated quickly. This clogs up the urgent pathway and is undoubtedly more expensive.

It is clear many PCTs do not trust GPs' clinical judgment, or believe that they will refer appropriately. The restrictions also demonstrate a very poor understanding of the impact on patients and the clinical consequences of a cost-cutting decision.

However, greater access to diagnostics by GPs has the potential to save money and improve care for all manner of condtions.

Commissioners need to ensure that they are making best use of finite NHS resources, but not at the expense of patient care or in a way that could delay diagnosis of cancer.

This is one area where GP commissioners, with their medical training and understanding of the patient experience, will obviously make a better fist of things than PCTs.

Direct GP access to diagnostics is essential if we are to improve cancer outcomes.


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