Practices in England are to get full rights to send patients with vague cancer-linked symptoms for direct testing, it was announced today.

NHS England claimed the moved could enable early diagnosis of tens of thousands of cancers while GP leaders praised it as a “positive step”. Under the new rules, GPs and other practice staff can order CT scans, ultrasounds and brain MRIs for patients with symptoms that fall outside guidelines for urgent, suspected cancer referral.

Patients should have to wait no longer than four weeks for answers in a move that NHS England hopes will also reduce the number of direct referrals to specialist hospital teams. It said GPs should continue to comply with National Institute for Health and Care Excellence guidance when a patient meets the criteria for urgent referral.

NHS chief executive Amanda Pritchard will say 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.”

The Royal College of Radiologists is advising GPs to use its bespoke decision making system “iRefer” to help them decide when to order tests.

President Dr Katherine Halliday 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 wholly welcome today’s announcement, the positive impact it will have for patients and any pressure reduction for our stretched radiology departments.”

Royal College of GPs chair Professor Martin Marshall said: “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.”