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Emma Wilkinson reports on new research focussing on GPs' role in cancer referrals

Waiting times for colorectal cancer treatment have spiralled since the introduction of the Government's two-week referral target, the leaders of a new study claim.

The researchers warned the target was 'completely flawed' and had succeeded only in overloading secondary care services ­ after finding overall waits had more than doubled since the introduction of the two-week rule in July 2000.

Targets for GP referral had been successfully met, according to the Plymouth-based audit, with the average time between referral and hospital appointment dropping from 31 days in 2000 to 14 days in January 2004.

But over the same period, the time from GP referral to diagnosis leapt from 15 days to 54 days, while the time from referral to treatment more than doubled from 92 days to 201 days.

Lead researcher Mr Ken Hosie, consultant in colorectal surgery at Derriford Hospital in Plymouth, warned: 'Access to care has got progressively worse since the introduction of the two-week wait, despite meeting the Government's two-week target.'

He described the situation as 'appalling' and said lack of funding meant diagnostic services were overloaded.

Mr Hosie, who is due to present his data at the British Association for Surgical Oncology conference in London this week, added that plans for colorectal cancer screening would further swamp endoscopy services.

The Government has pledged to increase funding for endoscopy with services under increasing pressure from the referral target.

Dr Richard Sullivan, head of clinical programmes at Cancer Research UK, said GPs were given a hard time over referral for cancer and were 'damned if they did and damned if they didn't'.

He stressed that referral was only the beginning of the treatment process and that many of the problems occurred later. 'It reminds me of a sausage,' he said. 'You squeeze one bit but then you get a bulge somewhere else.'

Tale of woe for two-week referral target

Oct 2003 Government advisers warn two-week referral rules are unworkable after official figures show four in 10 women with breast cancer are referred non-urgently

Dec 2003 Study finds GPs are not referring lung cancer patients under the two-week wait because rules are too bureaucratic

Feb 2004 Researchers in Portsmouth find fast-tracked colorectal cancer patients do not get diagnosed or treated any more quickly than routine referrals

Mar 2004 Three-quarters of consultants say they feel the two-week referral rule for skin cancer is not working

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