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New GP cancer 'target'

The head of the NHS expects GPs to halve the number of cancer patients whose diagnoses they miss.

Sir Nigel Crisp, NHS chief executive, told MPs the number of patients missed by GPs was 'too high', but he was confident of securing dramatic improvements.

Sir Nigel told the Public Accounts Committee: 'About 40 per cent of people who are subsequently found to have cancer did not come through the urgent referral system. The reason is they were not identified right at the outset by the GP as being likely to have cancer.' But he insisted: 'We think we can get that 40 per cent down to about 20 per cent by working with GPs.'

The Department of Health denied the announcement amounted to a new target for GPs. But it said NICE guidance would be the 'main driver for increasing the number of appropriate referrals'.

The Government's cancer tsar Professor Mike Richards, who also gave evidence to the committee, said there was a raft of measures in development alongside NICE guidance to reduce inappropriate referrals ­ including decision support tools and diagnostic algorithms.

Professor Richards told Pulse there would be no problem halving the number of missed diagnoses. 'With a combination of these approaches and making sure the guidelines are disseminated [hitting the 20 per cent figure] will be a non-problem.'

But GP cancer experts were sceptical that NICE could have the predicted impact.

Dr Willie Hamilton, a former GP and clinical research fellow in the department of primary health care at the University of Bristol, said he didn't believe the 20 per cent figure was achievable across the board.

Dr Hamilton, who is piloting an algorithm for referring patients with suspected colorectal cancer in 25 GP surgeries around the UK, said: 'The idea behind the NICE guidance is great, but if we take colorectal cancer as an example, quite a few patients have symptoms which simply don't qualify for a two-week referral. So, within colorectal I can't see 20 per cent ever being achieved.'

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