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GP leaders demand ‘full investigation’ into rejected radiology referrals



Exclusive GP leaders are demanding ‘full investigation’ into ‘hundreds’ of radiology referrals that have been returned to GPs across Birmingham.

Birmingham LMC said many of the referrals, which have been returned by the city’s major hospitals managed by the University Hospitals Birmingham NHS Foundation Trust (UHB Trust), were for potential cancer.

The LMC told Pulse that some urgent referrals, particularly for very likely colorectal cancer, have been returned by the trust three months after the referral was sent. 

It comes as earlier this week, Pulse revealed that hundreds of radiology referrals, including those considered urgent, have also been rejected by London’s Whipps Cross Hospital.

Dr Robert Morley, executive secretary at Birmingham LMC, told Pulse: ‘Hundreds of radiology referrals have been returned by Birmingham trusts – many of these were investigations for potential malignancy.

‘There have also been a number of urgent suspected referrals for very likely malignancy, particularly colorectal, returned by UHB Trust, sometimes two or three months after the referral was sent, with no action having been taken and inappropriately requesting the GP manage these patients.

‘These particular incidents have been absolutely shocking; the LMC has raised concerns with NHS Birmingham and Solihull CCG and the trust. The LMC’s position is that all these unacceptable incidents must be fully and properly investigated.’

Dr Richard Mendelsohn, chief medical officer at NHS Birmingham and Solihull CCG, said: ‘We are aware of a small number of direct access imaging requests that have been returned to the referring GP practice and can confirm that these have all now been dealt with.

‘Due to Covid-19, a number of measures have been put in place at hospital trusts to temporarily stand down non-urgent imaging requests and ensure that urgent requests for suspected cancer, trauma and infection are prioritised and dealt with in a timely way.

‘The concerns that we are aware of have been escalated to the hospital trusts concerned, investigated and the findings used to improve future management.’

Pulse has also contacted UHB Trust for comment.

Birmingham is not the first area where GPs have voiced concern at inability to get patients reviewed by specialists. 

GPs told Pulse that at least 400-500 radiology referrals had been rejected across practices in the London borough of Waltham Forest, including some for urgent cancer investigation. Meanwhile, NHS Mid and South Essex CCGs had told GPs to hold off routinely referring patients to secondary care altogether.

NHS England had warned in March that some urgent cancer referrals from GPs may need to be downgraded or avoided during the coronavirus emergency, but added that hospitals ‘may not downgrade urgent cancer referrals without the consent of the referring primary care professional’.

And, since April, NHS England has told hospital trusts to ensure GPs can continue referring as usual on the understanding that secondary care holds responsibility for delays caused by the pandemic.

It comes as cancer appears to have been particularly affected as a result of the pandemic. The Government’s Covid-19 recovery strategy cited a ‘53% drop in urgent cancer referrals for the week of 27 April in England, and the disease area was identified as a priority in the plan to begin restoring non-Covid services.