GPs given expanded access to tests to speed up cancer diagnosis

GP practices in England are being given expanded direct access to diagnostic scans for patients with concerning symptoms but who fall outside the NICE guideline threshold for an urgent suspected cancer referral.

NHS England has announced that from this month every GP team will start to be able to directly order CT scans, ultrasounds or brain MRIs for selected patients. Data shows that around one in five cancer cases are detected after routine testing following referral to a hospital specialist and this means some people can wait much longer for a diagnosis.

The new scheme will allow GPs to order these checks directly with the aim of reducing wait times to as little as four weeks.

NHS England believes that this could free up “hundreds of thousands” of initial hospital appointments by reducing the need for a specialist consultation first – “boosting efforts to address the Covid backlog that have inevitably built up during the pandemic”.

It estimates that around 67,000 people usually diagnosed with cancer through non-urgent testing will be eligible for fast-tracking, with a better chance of early diagnosis when survival rates are higher.

Urgent cancer referrals have been at record levels since March 2021, with over a quarter of a million people (255,055) checked following an urgent GP referral in August – the highest number since records began.

Richard Evans, CEO of the Society of Radiographers, said: “Everyone working in health care knows that earlier diagnosis is key to improving outcomes for patients with cancer and many other conditions.

“The opportunity for primary care clinicians to refer cases that have concerning features directly for imaging could help to achieve an earlier diagnosis for many people and this has to be a good thing. It’s important that the growth in workforce is prioritised in order to support initiatives such as this”.

Professor Martin Marshall, Chair of the Royal College of GPs, commented: "GPs want to ensure timely diagnosis for their patients, so that those with cancer can receive the appropriate treatment, and those without can be reassured. This is why the College has long been calling for GPs to have better access to diagnostic testing in the community, and whilst the devil will be in the detail as to how it will work in practice, today’s announcement is a positive step.

“It will be vital that alongside direct access to diagnostics, GPs receive appropriate support and additional training to interpret the test results and that relevant IT systems used for booking tests are integrated into those that GPs already use. We also need assurances that diagnostic hubs are appropriately staffed to cope with increased demand for testing - and that safeguards are put in place to prevent this new system inadvertently adding to the workload of already over-stretched GP teams."