NHS gives GP teams direct access to tests to speed up cancer diagnosis

Tens of thousands of cancers could be detected sooner each year thanks to a national roll out of fast-track testing, NHS chief executive Amanda Pritchard has announce today, 16th Nov 2022.

NHS England is expanding direct access to diagnostic scans across all GP practices, helping cut waiting times and speeding up a cancer diagnosis or all-clear for patients.

From this month, every GP team will start to be able to directly order CT scans, ultrasounds or brain MRIs for patients with concerning symptoms, but who fall outside the NICE guideline threshold for an urgent suspected cancer referral.

Around one in five cancer cases are detected after routine testing following referral to a hospital specialist, meaning some people can wait much longer for a diagnosis.

The scheme will allow GPs to order these checks directly, helping to cut down wait times to as little as four weeks.

Hundreds of thousands of initial hospital appointments could also be freed up under the approach by reducing the need for a specialist consultation first – boosting efforts to address the Covid backlog that have inevitably built up during the pandemic.

Under the ambitious Direct Access scheme, around 67,000 people who are usually diagnosed with cancer through non-urgent testing will now be eligible for fast-tracking – and can have a better chance of having their disease picked up at an earlier stage, when survival chances are higher.

GP teams will continue to follow NICE guidelines for referring patients to urgent cancer pathways. But the scheme will see patients who have vague symptoms and fall outside these standards offered quicker checks.

Not only can it help identify cancer cases earlier, but it will also offer peace of mind to those with concerning symptoms by letting them know they are cancer free.

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.

NHS chief executive Amanda Pritchard, said at NHS Providers annual conference in Liverpool: “GPs are already referring record numbers of patients for urgent cancer referrals, so much so that the shortfall in people coming forward for cancer checks caused by the pandemic has now been eradicated.

“This new initiative builds on that progress, supporting GPs to provide more opportunities for testing across the country for people who have vague symptoms.

“By sending patients straight to testing, we can catch and treat more cancers at an earlier stage, helping us to deliver on our NHS Long Term plan’s ambitions to diagnose three-quarters of cancers at stages one or two when they are easier to treat.

“As ever, if you have a potential cancer symptom – please come forward and get checked – it could save your life”.

The NHS will build on existing hospital diagnostic services with the significant additional capacity provided by Community Diagnostic Centres and, over time, will support primary care teams to boost the number of GP Direct Access tests available.

Dozens of the ‘one stop shops’ have already been introduced in hospitals and town centres across the country since July 2021, which are on track to provide at least three million tests this year.

There are plans to open up to 160 in total over the next two years, with around nine million annual checks delivered by the end of 2025.

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”.

Dr Katharine Halliday, President of the Royal College of Radiologists, said: “For a patient with cancer, every day counts. Quicker diagnosis means less invasive treatments, better recovery and better outcomes.

“Expanding direct access to diagnostic scans across all GP practices is welcome, but GPs aren’t radiologists and as scans become ever more complex, it’s essential that GPs are able to book the right scan, avoiding costly repeat scanning and devastating delays in treatment.

“We developed the iRefer Clinical Decision Making System to enable GPs to book the right scan first time, speeding up diagnosis and saving patient lives, as well as saving money and time. We wholly welcome today’s announcement, the positive impact it will have for patients and any pressure reduction for our stretched radiology departments”.

Louise Ansari, National Director of Healthwatch England, added: “People tell us that when they experience unnerving symptoms they need quicker and easier access to diagnostic tests to either give them reassurance that nothing is wrong or spot problems early so they can have a treatment plan put in place.

“This new initiative will give every GP practice in the country much greater flexibility in what tests and scans they can order for their patients.

“Ultimately, we hope this will help diagnose people who have cancer as early as possible, leading to better quality care and better long-term survival rates”.

While Phase 1 of the scheme will deal with urgent cancer referral pathways, Phase 2, which will be built up in 2023/24, will include a wider range of tests which will involve dialogues with GPs, integrated care boards and key stakeholders.

As part of the NHS Long Term Plan, the NHS committed to diagnosing three in four cancers at stages one or two by 2028.

Record numbers are being referred for cancer checks and the number of people receiving cancer treatment also continues to be high, with well over 27,000 people starting cancer treatment in August.