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Independents' Day

Allocations still with us

A quarter of patients with lung cancer miss out on diagnosis or suffer delays because abnormal chest X-rays are not acted upon, a new study reveals.

Medical defence bodies urged GPs to follow up patients referred for chest X-ray as two further studies also warned of failings in the system for referral and diagnosis.

The new audit of a 'safety net' at a clinic in Manchester found 73 of 269 patients would have had delayed or no action if a system of nurse follow-up had not been in place.

X-rays were more likely to be acted upon when ordered by a GP than a hospital doctor ­ but 10 per cent of GPs' patients would still have missed out on diagnosis without the safety net.

The researchers, who presented their data at the British Thoracic Society winter meeting in London, blamed administrative errors for the failure to act on X-rays.

They said their new system, costing just £2,500 per year, had prevented two 'adverse events or legal claims' a month.

Dr Pete Turkington, consultant chest physician at Hope Hospital in Manchester, said: 'We prevented two patients a month missing the opportunity of being diagnosed with lung cancer ­ 73 out of 269 hadn't had urgent follow-up. There's various reasons why the chest X-ray may not be acted upon. It could be that it didn't land on the physician's desk or the report was ambiguous.'

Dr Karen Roberts, clinical risk manager at the Medical Defence Union, said: 'Delayed diagnosis is one of the most common reasons for a claim being made against GPs. In many cases the delay is not due to clinical error but a simple failure to track the patient.

'Where a GP referral marked urgent had failed to appear the GP could still be liable if they did not recognise there was a delay and subsequently ask the relevant consultant why.'

Another study presented at the BTS meeting by doctors from Queen Elizabeth Hospital in Woolwich, south-east London, found the median time to diagnosis of lung cancer had increased by an average of 10 days since 1998.

And researchers at the Liverpool Lung Cancer Unit found there was no difference in tumour stage in patients who underwent surgery before or after the Government's 62-day target. Almost all patients diagnosed in 42 days were at stages I or II.

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