By Lilian Anekwe
Research into the impact of offering GPs direct access to diagnostic tests suggests that contrary to fears over misdiagnosis and over-referrals, GPs get it right and improve patient care.
The analysis was commissioned by PCTs ‘to demonstrate the usefulness of direct access to diagnostic tests’ and led by InHealth, a private provider of testing facilities at the London NHS Diagnostic Services, to which GPs can directly refer patients for community-based diagnostic tests.
The audit of 800 patients directly referred by their GP between March 2009 and March 2010 for a MRI, ultrasound scan or echocardiogram found only 29% were referred on to a specialist after they received an abnormal report. 71% of patients were managed in primary care by GPs given appropriate guidance.
The study will be submitted to the RCGP and the Royal College of Radiologists, who are currently developing the initiative for increasing the access to diagnostic imaging for primary care. Dr Sarah Wilson, medical director at InHealth, concluded: ‘The quality of referrals was high with the right test being requested for the right clinical indications for patients who could appropriately be seen in a community setting.’
The findings were supported by Dutch research, published in the June issue of the British Journal of General Practice, which found direct GP access to ultrasound ‘contributed to more accurate diagnoses and improved GPs’ management of women with abnormal vaginal bleeding’.
The study, of 122 women referred by 18 GPs to a specialist centre in Amsterdam between June 2003 and December 2004, found the ultrasound confirmed GPs’ diagnosis in 77% of cases with no structural pathology and 59% of patients referred for suspected fibroids.
GP access to diagnostics ‘improves care’