Practices are to get direct access to diagnostic checks for cardiovascular and lung diseases, it was announced today.

The move follows the successful introduction of direct access pathways for patients with suspected cancer – but some GPs believe it is aimed at shifting work from secondary care to practices. NHS England said it would enable patients fast access to diagnostic tests for a “wide range” of conditions, forecasting that a million patients a year would benefit. New “one stop” centres at hospitals and community diagnostic centres will also offer FeNO testing for asthma, blood tests for heart failure and spirometry testing for lung conditions.

GP leaders expressed concern that the moves would increase the workload on practices, who will face additional steps before they can refer patients to secondary care.

Dr Vin Diwakar, NHS England medical director for secondary care and transformation, 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.NHS staff are already making significant progress in reducing the COVID backlogs, and this efficient way of testing, can potentially help us to reduce that even further.”

Dr Kieran Sharrock, the acting chair of the British Medical Association’s GP committee in England, said: “It’s time our politicians stop playing whack a mole with our NHS. The entire health service is struggling to cope with demand and the only way to fix the issues at hand is to provide the NHS with adequate funding.”

He added: “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.

“Patient referral is a complex process, and many GPs report that their referrals are being returned or blocked by the advice and guidance system with demands for further investigations, treatments, information. GPs then must re-refer and this not only increases workload but causes further delays for patients. While NHSE suggest they want to enhance GP access to direct diagnosis and shift the workload from hospitals it makes no reference to how it plans to fund the new work that will now be placed on already overwhelmed general practice.”