A senior GP rejects Government plans to bypass practices for cancer diagnosis

As reported by Practice Index, Dr Bramall-Stanier, a GP leader, has criticised Government plans to send patients directly for cancer tests without first having practice appointments.

A GP leader has criticised Government plans to send patients directly for cancer tests without practice appointments.

Health Secretary Steve Barclay revealed yesterday that his staff are working on plans for patients to be sent directly to diagnostic centres for cancer tests. Later on, NHS England announced details of its changes to cancer diagnosis and treatment targets, which, it claims, are widely supported by senior clinicians.

Responding to Barclay, Dr Katie Bramall-Stanier, chair of the British Medical Association’s GP committee for England, said the proposal seemed “seductively simple”. She warned that the plans could “rapidly overload” radiology departments.

Dr Bramall-Stanier said: “As a GP, my priority when triaging appointment requests in surgery is to look for these ‘red flags’ and bring the patient in as soon as possible, usually the same day. Like with the rest of the overwhelmed NHS, triage is essential – and GPs are expert generalists who have trained for years to know when a patient needs to be referred for cancer or if it could be something else.

“This suggestion might sound like a good idea, but it will rapidly overwhelm radiology departments, and lead to even longer waiting lists for scans, and potential missed diagnoses – putting yet more pressure on the NHS. I’m also worried that the Health Secretary hasn’t detailed where these diagnostic centres will be, and who will staff them. There is only one workforce, and we can’t magic up additional radiographers or radiologists out of thin air, just like we can’t magic up GPs; we have lost more than 2,000 full-time, fully qualified GPs since 2015 and the way things are, this will only get worse.

“The priority for such an overwhelmed NHS has to be safety. And GPs are integral to safe cancer referral processes – removing us from the equation risks patients falling through the net and those without cancer being put on the pathway by mistake or missed altogether.”

NHS England confirmed that ten performance standards for cancer will be reduced to three – including the 28 day “faster diagnosis” standard, which requires a decision on diagnosis within four weeks of referral.

The time from referral to treatment should take no longer than 62 days while treatment should also start within 31 days of a decision on treatment, according to the new standards.

NHS national clinical director for cancer Professor Peter Johnson said: “On top of delivering record checks and treatments, staff have also made significant progress bringing down the longest waits, but we want to ensure even more patients are being diagnosed and treated as early as possible following referral. These modified standards will provide a clear focus for how to achieve this, and the faster diagnosis standard already being used across the country will mean more patients will benefit from a speedier diagnosis or the all clear within a month, helping to relieve anxieties or enabling treatment to start sooner. Catching cancers early saves live and these three standards have been agreed by leading cancer experts, with the support of cancer charities and clinicians, as the best way for the NHS to ensure patients are diagnosed and able to start treatment quickly.”