GPs report rise in cancer referrals rejected unfairly during COVID-19 pandemic

One in four UK GPs say rising numbers of cancer referrals have been rejected inappropriately during the COVID-19 pandemic, amid concerns that thousands of cases of cancer may have been missed.

MRI scan (Photo: Monty Rakusen/Getty Images)
MRI scan (Photo: Monty Rakusen/Getty Images)

Around 25% of GPs said the proportion of cancer referrals rejected unfairly during the pandemic had increased compared with before it began, according to a poll of more than 1,000 GPs for the charity Cancer Research UK. In parts of the UK more than 40% of GPs said unfair rejections had increased.

Two in five GPs also said that 'safety netting' was not adequate when referrals were rejected - leaving patients 'in limbo' between their GP practice and hospital services.

Cancer Research UK estimates that as many as 300,000 fewer urgent cancer referrals have been made than normal during the pandemic. Around 5% of patients referred on the two-week pathway are found to have cancer - suggesting that as many as 15,000 cases may have been missed. 

Cancer referrals

A lack of capacity, limited access to diagnostic testing in hospitals and attempts to keep patients out of hospital to prevent COVID-19 infection are likely driving the rise in rejected referrals, the charity warned.

The poll findings come just over a month after GPonline reported that one in three GPs had seen urgent cancer referrals rejected during the coronavirus pandemic - and just over a month after Cancer Research UK revealed that 2.4m people were waiting longer for cancer treatment because of the pandemic.

Cancer research UK GP Dr Richard Roope said: 'GPs are doing all they can during these difficult times and it’s alarming that referrals are being turned away. Waiting for further tests can be an extremely worrying time for patients.

'In most cases, it won’t be cancer. But for those people who may be missing out on a potential cancer diagnosis, this is not OK. Those appointments that have been rejected need to be followed up.'

COVID-19

Dr Roope warned that problems with referrals could put some patients off contacting their GP to have worrying symptoms checked out - but said they must be urged to continue to seek help so that their GP 'knows and can keep fighting your corner for you to be referred'.

Cancer referrals are thought to have dropped by up to 75% in parts of the UK at the peak of the pandemic. The sharp drop was driven largely by patients being reluctant to visit hospitals or GP practices during the outbreak - but Cancer Research UK said its latest findings showed that 'referrals being rejected was also a problem'.

Around 5% of the 233,000 people referred on the two-week cancer referral pathway each month are likely to be confirmed as having cancer. Reduced referral rates have seen around 300,000 fewer urgent suspected cancer referrals during the pandemic than would normally have occurred during the period - suggesting that many patients with cancer may simply have been missed.

Cancer Research UK chief executive Michelle Mitchell said: 'It’s deeply concerning that suspected cancer patients are being refused hospital appointments despite being referred by their doctor. And even more worrying that they may be slipping through the net.

'The NHS says it’s open for business, which remains a really important message to encourage people to come forward with symptoms. So, we need to be confident that patients will receive the care they need and able to reassure people that they won’t be lost in the system that is also facing a mounting backlog.'

An NHS spokesperson said: 'NHS staff worked incredibly hard to ensure that, alongside treating 100,000 people for severe problems related to COVID-19, essential and urgent cancer treatment was able to go ahead safely - even during the height of COVID, 340,000 people were referred urgently with suspected cancer symptoms and 90% saw a doctor within two weeks.

'While for some people expert clinicians will have assessed that it was safer for them to wait for certain tests or treatments, we know that the main concern for doctors is the reduction in people coming forward for cancer checks, and we would urge anyone worried about symptoms to get in touch with their GP like they usually would.'

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