GPs to order “fast-tracked” tests for heart and respiratory conditions

GP practices in England will be able to directly order “fast-tracked” diagnostic tests for a range of respiratory and heart conditions as part of measures announced by NHS England.

It says up to one million patients could benefit from the accelerated access, reducing the need for a specialist consultation and speeding up potentially life-saving treatment and medication for patients.

A similar initiative already in place for cancer is said to have provided quicker access to tests for almost 80,000 people who may not meet the NICE guidance threshold for an urgent cancer referral.

Plans call for local hospital or community diagnostic centres to become “one-stop shops” for scans and tests, such as FeNO testing for asthma, blood tests to identify people at high-risk of heart failure and spirometry testing which can help diagnose lung conditions, including COPD.

Medical Director for Secondary Care and Transformation, Dr Vin Diwakar, said: “We know how important it is to diagnose people with conditions like heart failure, COPD and asthma early, so they can get the treatment they need to manage their condition well, and to prevent more serious conditions or illness from developing.

“Our plans to enhance GP direct access will enable thousands more to get a vital diagnosis sooner, and by capitalising on the additional capacity provided by over a hundred community diagnostic centres offering a ‘one stop shop’ for tests in the community, patients can benefit from convenient triaging and testing near their homes – and importantly, avoid a hospital admission or trip to A&E.”

Professor Kamila Hawthorne, Chair of the Royal College of GPs, said: “Any initiative to accelerate the process by which patients can be diagnosed and begin to receive any necessary treatment should be seen as positive.

“The RCGP has long been calling for better access to diagnostic tests and tools for GPs in the community as a means of ensuring that serious conditions are identified at the earliest possible stage. GPs are highly trained to refer appropriately for specialist care and will only do so if they think it is the best interests of their patients, but improved access to diagnostics will undoubtedly support them in this decision.

"For this initiative to be successful, it is vital that diagnostic capacity - both in terms of testing, and people to conduct and interpret tests - is sufficient, and that there is close coordination and clear communication between GP practices and secondary care teams.”

Dr Kieran Sharrock, acting chair of GPC England at the BMA, commented: “While we acknowledge NHS England’s efforts to tackle winter pressure demands, the notion that it can do so by increasing the GP workload is frankly counteractive.

“These kinds of fast-tracked diagnostic referrals come with the expectation that additional work, such as performing complex investigations not part of a normal GP service, will be done prior to referral and NHSE has provided no details on how already overstretched GPs will undertake the extra work required.”