Some patients are 60 times less likely to get a cancer scan in postcode lottery
01:07 GMT, 31 July 2012
Up to a fifth of GPs are failing to send enough patients for life-saving scans to diagnose cancer, researchers warn.
While some doctors are missing symptoms, others are being actively discouraged from referring patients by cost-cutting NHS managers.
A study published today shows that patients with suspected cancer in parts of England are 60 times more likely to be sent for scans than those living elsewhere.
Postcode lottery: Researchers warn a fifth of GPs are failing to send enough patients for life-saving scans to diagnose cancer. (Posed by models)
Researchers say this is partly due to a ‘lack of awareness’ among some GPs which means they are failing to spot possible symptoms.
But they also warn that family doctors are frequently being ‘told off’ by hospital consultants or managers at primary care trusts for apparently sending in patients ‘unnecessarily’.
Under Department of Health guidelines, anyone with suspected cancer is meant to undergo an urgent scan within two weeks of them first seeing their family doctor.
But research by the National Cancer Intelligence Network has shown that patients’ chances of being referred for these tests depend entirely on where they live, and with which GP practice they are registered.
In some surgeries only 89 out of 100,000 patients are being sent in for urgent cancer tests within two weeks.
This is a fraction of the average across England, which is 1,800 per 100,000 patients. And in some practices more than 5,500 per 100,000 patients are referred for a test within two weeks.
Dr Mick Peake, lead clinician of the NCIN, warned that between 15 and 20 per cent of family doctors were ‘under-referring’ – sending too few patients for scans.
‘There is evidence of underperformance here,’ he said. ‘I think doctors are being told off by hospital doctors for sending unnecessary people up. Second is their own lack of awareness.
There are some GPs who are less aware, less alert. The PCTs are actually trying to discourage GPs from referring.’
Guidelines: Anyone with suspected cancer is meant to undergo an urgent scan within two weeks of them first seeing their family doctor
Cancer survival rates in Britain are consistently among the lowest in Europe and researchers say this is partly because the illness is frequently diagnosed too late.
Last year it emerged that a quarter of PCTs had policies in place urging family doctors to ration the number of patients they send for cancer scans.
Trusts have to pay hospitals for every patient undergoing a scan which can be up to 600 on top of the cost of them seeing a specialist.
But Dr Peake said that in order to ensure those patients with cancer were diagnosed early, family doctors should feel free to refer anyone they thought could have the illness.
Sarah Woolnough, of Cancer Research UK, said: ‘We urgently need to learn more about what’s behind these differences and tackle any poor practice.
‘We already know that some patients present several times with cancer symptoms before being referred for further investigation, which can lead to late diagnosis. And a delayed cancer diagnosis could prove critical for a patient’s chance of survival.’
The study by the NCIN – which is part-funded by the Government to improve cancer research – looked at data for nearly all 8,000 GP practices in England.
One of the lowest rates was for a practice in Hillingdon PCT, West London. The highest were found in a surgery in Sefton PCT, near Liverpool.
But there is also concern that some GPs are referring patients unnecessarily for scans when their chance of having cancer is extremely low. This causes patients needless worry and can lead to longer waiting times for those who do have the illness.
Professor Sir Mike Richards, the Government’s National Cancer Director, said: ‘Everyone with persistent symptoms which could be cancer should be checked out urgently. Where differences have been exposed, GPs should consider their referral practices.’