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GP cancer referral threshold to be lowered as part of NHS long-term clinical goals

GPs will have fewer barriers to making cancer referrals in a bid to catch more cancers earlier, NHS England announced as part of its new long-term plan for the health service.  

NHS England said that it aimed for the proportion of cancers diagnosed at stages 1 and 2 to rise to 75% of cancer patients by 2028, compared to current levels of around 50%. 

The plan said achieving this ‘will mean that, from 2028, 55,000 more people each year will survive their cancer for at least five years after diagnosis’.

The document said: ‘We will build on work to raise greater awareness of symptoms of cancer, lower the threshold for referral by GPs, accelerate access to diagnosis and treatment and maximise the number of cancers that we identify through screening.

‘This includes the use of personalised and risk stratified screening and beginning to test the family members of cancer patients where they are at increased risk of cancer.’

The announcement comes less than six month after figures published by NHS England spanning April to June 2018 found that the time to treatment target scores for both GP referral and the cancer screening programme had hit an all-time low.

In November, NHS England announced a major overhaul of cancer screening programmes, with GP experts demanding a closer examination of target cancer screening schemes so that the most appropriate patients benefit.    

The programmes suffered two scandals last year including revelations that primary care support provider Capita failed to pass on nearly 48,000 letters regarding cervical cancer screening to patients.

Other clinical measures introduced in NHS England’s plan include:

  • Increasing the proportion of known sufferers of familial hypercholesterolemia (FH) by improving access to genetic analysis;
  • The creation of a national cardiovascular disease prevention audit for primary care;
  • People with heart failure and heart valve disease to be supported by multi-disciplinary teams as part of primary care networks; 
  • Parients with musculoskeletal issues gaining direct access to ‘first concact’ practitioners, without needing a GP referral.

The plan said: ‘Working with local authorities and PHE, we will improve the effectiveness of approaches such as the NHS Health Check, rapidly treating those identified with high-risk conditions. Working with voluntary sector partners, community pharmacists and GP practices will also provide opportunities for the public to check on their health, through tests for high blood pressure and other high-risk conditions.’

NHS England’s long-awaited plan for the future of the health service has laid out plans to mandate GP practices to form networks of 30-50,000 patients and has also called for the Government to tear up health and social care act competition rules around health service procurement. 



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