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GPs go forth

Trusts unable to keep up with increase in GP cancer referrals

Health and social care trusts must improve their performance to ensure patients start cancer treatment on time following GP referrals, Northern Ireland’s public accounts committee has said.

In a report examining health and social care sector performance during 2012/13 and 2013/14, the committee highlighted that no hospital was able to ensure that 95% of patients began their treatment for cancer within the 62-day standard.

The committee also said it was ‘worrying’ that the proportion of patients seen within 14 days of an urgent referral for breast cancer had fallen from 84% in 2013/14 to 81% in 2014/15.

Meeting the standards has been difficult because the number of GP referrals has increased in recent years, the committee concluded.

The report states: ‘While delays in all types of appointments can cause pain and distress for patients and their families, the committee was particularly concerned that trusts have been failing to meet important cancer waiting time standards for patients.

’Performance against the standard that 95% of cancer patients should start treatment within 62 weeks of being urgently referred by a GP is a crucial indicator of the readiness of the health and social care sector.’

Readers' comments (7)

  • Anyone surprised by this!

    NICE shot themselves in the foot when they developed this new risk grading.

    You see how many patients the system can cope and then fix the target risk at or above that else have a bottomless pit.

    They should have used Q Cancer risk stratification and set the PPV at 10% or higher for inclusion in 2ww referral rather than PPV of 3% on non selected individuals.
    It actually makes it worse for those who have cancer.
    Maybe they need 2WW for PPV10% and 4WW for PPV3-10%.
    (PPV = positive predictive value)

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  • Reasons why referrals(2ww or others) will just keep going up

    Nice guidelines
    Mr Hunt says google your symtoms
    Ligitation risks too high
    Helps to reduce my workload - no need to 'review'
    Follow-up and continuity to see same dr impossible due appoitment demands.
    Using locums.
    Investigations radiological/blood etc too cumbersome and does not help practice budgets
    And Many others!!!!

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  • One can't throw the whole responsibility on Trusts. Lack of funding is making life miserable and causing failures on all fronts. It's callous and flawed policies that have resulted in a total rout of care in NHS. Patients referred as urgent to orthopaedics and neurologist are waiting for more than 6 months and if you refer a HF to cardiac fast track, they are being told that they do not need treatment and Consultant doesn't need to see them.
    Cancer is just one problem which is a quick killer but there are others dying of conditions where deaths can be avoided with a lesser effort.

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  • I have evidence that a Medical negligence lawyer will always accuse you 'did you refer' - a wise GP needs to refer regardless to time it takes to seeing a specialist. Also see the GMC guidelines says 'do not assume you are a specialist'

    Remember you may be just a messenger in this system. The buck will never stop with Mr Hunt.

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  • New NICE guidelines came into force in June 2015 so after this report's findings.

    In terms of risk, international comparisons show that one of the key reasons for poor one year survival in the UK is the bar is set too high before we access specialist advice/diagnostic tests to rule out cancer.

    2WW or 4WW patients still need to be seen. Much better to have single queue set at low threshold.

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  • Samuel Lewis

    Once upon a time your referral letters were read by the Consultant, who then accorded priority, and picked out those he would see in his next clinic.

    Some patients waited forever, presumably because the specialist always found someone more urgent.

    So waiting-list initiatives, priority clearing, waiting time directives, referrals management and guidelines have grown apace.

    So much better isn't it (not).

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  • Lower thresholds for referral but no extra resources. Now those who you really think have a high chance of malignancy face the same priority as everyone else. Splendid.

    What can we expect when we have King Canute at the helm?

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