A hospital has told GPs its administrators may inform patients that they have suspected cancer unless GPs are explicit to patients when using the two-week urgent referral pathway.
Local GP leaders said that John Radcliffe Hospital in Oxford is introducing the ‘blunt’ strategy because GPs are not conveying the urgency of the referrals, meaning patients are refusing the appointments on ‘trivial’ grounds, such as going on holiday.
Berkshire, Buckinghamshire and Oxfordshire LMCs’ chief executive Dr Paul Roblin said that he could see ‘both sides’ of the argument, and that the hospital was acting to ensure patients didn’t delay further investigations.
However, he added the news needed to be broken sensitively, particularly because the staff arranging appointments were unlikely to be ‘clinically proficient or have the clinical skills to deliver the news in the right way’.
The LMC has written to practices outlining that, when making a two-week wait referral, they should also make clear their first appointment will need to happen within two weeks, and could be at the first available hospital, so their plans might need to be altered.
Dr Roblin said: ‘If a patient isn’t aware, that a pretty blunt and potentially distressing way for patients to find out.
‘So I’ve encouraged practices to be clear with their patients that two-week wait means cancer is a possibility. And the GP can develop that to deal with each patient as an individual.’
He said it is ‘variable’ whether GPs do it at present, and that is the reason the hospital has taken that stand.
Dr Roblin said: ‘When the hospital has phoned up with an appointment in two weeks, patients often say “well I can’t make that”, and the hospital has to say “you are being referred for the exclusion of cancer, do you realise that?”
‘So I do sympathise with both sides, GPs need to play their part in informing patients, but the John Radcliffe has to deal with patients in a sensitive way. Especially if it’s administrative staff offering the appointments, they’re not clinically proficient and they have to have the clinical skills to deliver that news in the right way.’
Urgent GP referrals for cancer have increased 50% in the last five years, largely because of awareness campaigns and drives to boost GP referring. But the two week wait target could soon be scrapped, as a Government cancer target has suggested replacing it with a four week target for diagnosis.
Oxford University Hospitals were approached for comment but had not replied at time of publication