Direct access to cancer tests urged for GPs


GPs must be given direct access to tests for cancer in a bid to speed up diagnosis, a health watchdog has said.

In a new quality standard, the National Institute for Health and Care Excellence (Nice), said doctors must be able to directly refer patients with suspected cancer for endoscopy, ultrasound, MRIs, X-rays and CT scans.

The idea has been touted for a number of years, with the Department of Health publishing guidance on the issue as far back as 2012.

But evidence suggests GPs do not always have access to these tests or do not push for them, with an investigation by GP magazine in 2014 showing as many as half of GPs were being denied direct access to basic diagnostics for cancer.

Responses from 182 clinical commissioning groups (CCGs) in England to a GP Freedom of Information request revealed that a large proportion were preventing GPs from having direct access to diagnostics.

Less than a third (30%) commissioned direct access to all four tests set down by the Department of Health (including ultrasound for ovarian cancer and MRIs for brain cancer), and almost one in four (22%) commissioned none at all.

In its new standard for suspected cancer, Nice said CCGs and NHS England must ensure that systems are in place for GPs to send people with suspected cancer directly for diagnostic tests.

It added: "People who are sent for these tests directly by their GP will find out whether or not they have cancer faster than if they were referred using a cancer pathway."

In addition, Nice said patients who have symptoms of possible oesophageal or stomach cancer must have urgent direct access to upper gastrointestinal endoscopy tests.

In a bid to ensure people attend appointments, Nice said people with suspected cancer should be given written information "encouraging them to attend".

Research published in 2009 estimated that up to 10,000 lives in England could be saved every year if cancer was diagnosed earlier and more appropriate surgery was used as a first treatment.

Professor Gillian Leng, deputy chief executive of Nice, said: "When we published our updated suspected cancer guidance last year, we said the best way to successfully treat cancer was to make an early diagnosis. It is a simple step that has the potential to save thousands of lives each year.

"In this quality standard we're highlighting the need to give GPs the ability to refer patients directly for key tests such as MRI, X-ray and CT scans for suspected cancer so we can make that process even faster.

"We also want to ensure that everyone who is referred for further tests attends their appointment as this could be vital for a swift diagnosis, but also because missed appointments delay other patients and waste precious NHS resources."

More than 300,000 new cases of cancer were diagnosed in the UK in 2013.

GPs can already send patients to see a specialist within two weeks if they suspect cancer. However, patients have to meet a certain criteria depending on the cancer type.