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GP care for cancer patient at ‘all-time low’, NHS England claims

Patient satisfaction with GP care during cancer treatment has fallen to an all-time low, NHS England has claimed, but GPs have said poor communication from secondary care is the major cause of dissatisfaction.

The National Cancer Patient Experience Survey 2014, published today, showed that while 89% rated their cancer care overall as ‘excellent’ or ‘very good’, only 66% agreed that GPs and nurses at their registered practice ‘did everything they could’ to support them during treatment.

The survey, which gathered responses from over half of the cancer patients undergoing NHS  treatment between September and November 2013, showed that around a quarter said GPs and nurses supported them ‘to some extent’, while 11% said that GPs ‘could have done more’.

But GP leaders said that problems arose from poor communication from secondary care providers, leaving GPs ‘completely cut out’ of cancer patients’ care.

The survey of 70,141 patients showed that only 63% thought that primary and secondary care health care professionals ‘worked well together’ to deliver the best possible care.

However, the rate of accurate referrals remained at a steady high, with 75% of patients reporting that they saw their GP only once or twice before being referred on to a cancer specialist (the same proportion as in the 2010 survey).

Health minister Lord Howe said that the Government, along with Cancer Research UK and Macmillan Cancer Care, were working with GPs to ‘further drive early diagnosis’.

He added: ‘The NHS is treating more patients for cancer than ever before, and we are seeing real improvements with 89% rating their care as excellent or very good. But we want every person diagnosed to have the best care and treatment regardless of where they live.’

Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee, told Pulse that while it was important for GPs to put their efforts into early diagnosis, communication between secondary and primary care had become ‘appalling’, leaving many GPs ‘completely cut out’ of cancer patients’ care.

He said: ‘In recent years, hospital communication with GPs has got absolutely awful. Often GPs can feel end up feeling that cancer care is very technical and specialised, and can feel a bit uncertain as to what their role is.

‘A lot of the time, GPs are just copied into the cancer register details, a four or five page document in which all the information is jumbled up in a non-sequential manner. It’s extremely difficult to extract information about what has changed in the patient’s care. GPs need a thoughtful letter from the responsible hospital clinician telling us what we need to know – not telling us the same thing over and over again in a completely jumbled fashion.’

He added: ‘While GPs are under pressure to cut down investigation rates and hospital referrals, there does seem to be a link between the amount of investigating that GPs do, and the rapidity with which patients are diagnosed with cancer.

‘There’s an assumption that low referral and investigation rates are good and not bad, but in fact in the field of cancer care it’s beginning to look like the pendulum needs to swing the other way, and we need to be a little bit more invasive in our investigations.’

Pulse reported earlier this week on the wide variation on timing of cancer diagnoses across the country. According to a Cancer Research report, nearly half of people with cancer are diagnosed at a late stage, partly because some GPs lack access to diagnostics which may detect cancer. These findings come three years after the Department of Health launched its Cancer Strategy – which included a pledge to invest £450 million in giving GPs more direct access to diagnostic tests.

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