GP cancer overhaul could see quicker referrals based on symptoms

Plans to overhaul GP cancer referral pathways could halve the number of appointments spent on diagnosis and improve patient outcomes, according to the RCGP's clinical lead for cancer care.

Dr Richard Roope

Dr Richard Roope said proposed multidiagnostic centres, currently being piloted by the DH, will allow GPs to refer based on symptoms rather than diagnosis, streamlining cancer care and allowing patients with vague symptoms to receive their diagnosis much faster.

‘Patients come to general practice with symptoms and not a diagnosis,’ said Dr Roope, who will be speaking at the RCGP annual conference this week. ‘One of the challenges in primary care has always been that, if a patient has vague symptoms like abdominal pain, GPs have to choose whether they are going to refer for upper GI, lower GI, gynaecological or urology tests.

‘You could investigate one avenue, and if that worked out – great. But if it didn’t, the patient would be referred back to you and you would then have to start again with a second diagnostic pathway.

‘We would have to arrange a series of diagnostic tests one after the other, which delays the diagnosis.’

Streamlining cancer referral process for GPs

Allowing GPs to refer on a symptom basis will streamline the process and make it easier for GPs to access cancer diagnostics.

‘We would refer our patients with, say, abdominal pain and they would then see a senior doctor or clinician who would arrange the appropriate tests. The patient would get a diagnosis almost on the day.

‘For a GP, the instant benefit is that there’ll be fewer consultations. At the moment, for more complicated cancers, it may take four or five consultations to refer patients. With these changes, GPs may do one round of preliminary tests and refer patients after the second consultation.’

The changes should help the UK to improve outcomes for patients with cancers that are difficult to identify in a GP consultation – such as pancreatic and ovarian cancers – where it has historically lagged compared with other European countries.

Preliminary results from the pilots are due in November and have ‘the potential to be very exciting’, said Dr Roope. If deemed successful, the plans could herald changes when the 2016/17 GP contract is drawn up.

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