Patients who think they may have cancer could be given the option to self-refer for investigation without the need for a GP referral, the Government has suggested.
A public call for evidence on a 10-year cancer plan, launched last week (4 February) listed this as a future option, alongside allowing pharmacists to refer patients with suspected cancers.
Introducing the consultation, the Government said it was ‘committed to accelerating progress’, for example via ‘working with primary care to trial new routes into the system via community pharmacy and self-referral’.
Meanwhile, in an accompanying speech, health secretary Sajid Javid said the evidence call ‘demonstrates the ambitious plans that we have for the next decade’, which could include ‘using community pharmacy and perhaps even self-referral’.
The news comes as the Government has already announced plans to expand a number of community diagnostic centres to speed up diagnoses – although the existing CDCs currently require a GP referral.
‘At least’ 100 community diagnostic centres are planned to be in place over the next three years, with 66 by the end of 2021/22 and an ambition to reach more than 160 across the country, the plan for clearing the NHS elective care backlog said yesterday.
It also set out plans to reduce diagnostic waiting times, with the aim of:
- At least 95% of patients receiving tests within six weeks by March 2025;
- Delivering the ‘cancer faster diagnosis standard’, with at least 75% of urgent cancer referrals receiving a diagnosis within 28 days by March 2024; and
- Returning the 62-day backlog to pre-pandemic levels by March 2023.
Professor Willie Hamilton, professor in primary care diagnostics at the University of Exeter, who has a particular expertise in cancer, noted that the idea of self-referral for cancer investigation had been ‘bubbling up for years’, having now ‘reached the surface’.
He told Pulse: ‘My stance is that with appropriate safeguards and very thorough entry criteria – for example, you can self-refer with breast lumps or certain lung symptoms – then I don’t have a problem with patients bypassing the GP.’
Meanwhile, addressing GP concern that self-referral could lead to cancer investigation resources being taken up unnecessarily, he added: ‘There is some strength to that argument but in cancer the gatekeeper theory may have been counterproductive.
‘GPs are brilliant when it’s not cancer but the people who suffer from the gatekeeping are those who do have cancer.’
But Professor Hamilton added: ‘I think most patients with cancer will benefit from seeing a GP and I don’t think there will be a rush to self-refer.
‘I think most people will value seeing their GP and I don’t think that many people will bypass that step.’
Click to complete relevant cancer CPD modules on Pulse Learning.