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Stop labelling GP referrals as ‘inappropriate’ says DH cancer tsar

By Nigel Praities

Pressure on GPs by NHS managers to cut referral rates is damaging the drive to diagnose cancers earlier, says a top DH adviser.

Cancer tsar Professor Mike Richards said hospitals should stop labeling referrals as ‘inappropriate’ and encouraged GPs to refer more often to detect cancers earlier.

The admission – in a roundtable debate organised by the RCGP– comes weeks after a hospital boss admitted patients with cancer were ‘sitting at home undiagnosed’, because of overzealous management of GP referrals.

Professor Richards said there needed to be a ‘culture shift’ in the NHS to recognise that increased GP referrals were needed to boost cancer survival rates.

‘Secondary care colleagues have got to stop using the word ‘inappropriate’ referral. If they can genuinely say ‘I didn’t do a single test when the patient came’ then that is different, but they don’t very often do that and how often do they say referrals in private practice are inappropriate? I don’t think they do that either.

‘On both sides we need a shift towards saying it is OK to investigate, in fact play it safe and investigate more than we have in the past,. I know that will cost money in terms of investigations, but it will also save lives,’ he said.

At the same meeting, Dr Willie Hamilton, a GP in Exeter and cancer diagnosis researcher said GPs should ‘gently ignore’ NICE referrals guidance and seek to refer suspected cancers more readily.

‘If we follow NICE to the letter then 50% of cancers would not be picked up. The only answer to this is to gently lower the threshold.

‘I am not talking about turning the tap right up so that we investigate willy nilly, we just have to drop that level a bit so that patients we would not normally investigate, we will investigate’ he said.

Stop labelling GP referrals as ‘inappropriate’ says DH cancer tsar RCGP Cancer meeting