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Managers want exception reporting axed from QOF

NICE has 'completely revamped' guidance on referral for suspected cancer in children in recognition of the emotional trauma involved in a missed diagnosis ­ for both parents and GPs.

The recommendations, which make up almost a fifth of the overall document, give detailed advice for spotting leukaemia, lymphoma, brain and CNS tumours, bone sarcomas and retinoblastomas.

They urge GPs to refer any young child who presents three or more times with the same problem but no clear diagnosis and say persistent parental anxiety is sufficient reason for referral.

'Most GPs will only see two or three cases of childhood cancer but it's very, very important as it can make or break a family and a doctor's career,' said guideline chair Dr Ivan Cox.

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