GPs face tougher scrutiny over diagnostic scans

Government plans to monitor GPs' use of diagnostic tests must set clear standards to avoid GPs being wrongly acc­used of inappropriate referrals, the RCGP has warned.

Scan access is often being restricted by PCTs to save money (Photograph: SPL)
Scan access is often being restricted by PCTs to save money (Photograph: SPL)

The DH has revealed that it is developing a new system to monitor NHS diagnostic testing activity, including direct access by GPs.

The move comes after a GP investigation last year showed GPs are facing intense scrutiny from PCTs over their referral to direct access scans, with some trusts restricting access to cut costs (GP, 9 September).

RCGP imaging lead and Yorkshire GP Dr Nick Summerton said there was no problem tracking use, as long as GPs were judged against appropriate criteria. But he suggested GPs must be prepared to defend their level of use if challenged by commissioners.

He told GP: ‘It always makes sense to ensure use is appropriate. The only issue would be around thresholds. I might have slightly lower thresholds for investigation than another GP,’ he said. ‘If mine is so low, I must have a good reason for why it varies,’ he said.

Whether GPs choose to send patients with symptoms for scans or not depends on many factors, he added.

These include clinical judgment, knowledge of latest research and even whether a GP agrees with NICE guidelines.

Any variation in use should be ‘an opportunity for dialogue rather than bashing GPs on the head’, he said.

The government outlined plans to scrutinise GP use of diagnostics in the first annual report on its cancer strategy, published last month.

The system will ‘enable detailed analysis of variation in activity and waiting times, including benchmarking of GPs’ direct access to particular diagnostic tests’, it said.

GPs will be sent a referral best practice guide to inform better use of such tests as part of the scheme.

The DH expects approval for the scheme from regulators later this month.

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