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Patients to book own chest X-rays under new cancer self-referral pilot

The new cancer self-referral project announced this week by NHS England will run in Mid Cheshire and will allow patients from socially deprived groups with a high risk of lung cancer to book themselves in for a chest X-ray.

According to NHS England, people living in particular areas of Crewe with high incidences of lung cancer and traditionally poor access to health services will be able to ‘self-request’ the tests.

The model of self-referral – enabling people to book their own appointments directly with a diagnostic testing unit or hospital, without first seeing a GP – is one of a range of measures NHS England is testing out as part of a programme of work aimed at diagnosing cancer earlier.

An NHS England spokesperson told Pulse: ‘We currently only have one site in Mid Cheshire which aims to test and evaluate this concept… The current project site is looking at offering a self-request chest X-ray service targeted at specific parts of Crewe where there is a higher incidence of lung cancer and where uptake of health services is traditionally poor. The self-referral concept means patients do not have to present via their GP.’

NHS England said removing the need for people to first see a GP could ‘potentially’ speed up the process of diagnosis, but GP leaders have warned the approach risks undermining GPs’ ‘vital gatekeeping role’.

Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee said he did not believe the approach would be helpful and warned of over-investigations – but that he was open-minded about the trial.

Dr Green said: ‘Any delay of a few days caused by the need for GP involvement will not turn a patient from treatable to untreatable, and the harms caused by over-investigation are likely to be significant.

‘However, this is only my belief and not proven, so why not have a proper trial, providing the results are subject to scientific and not political interpretation.’

So far the Mid Cheshire is the only site testing self-referral as part of the early diagnosis programme, although NHS England said it may look at starting further self-referral pilots.

The spokesperson added: ‘It is arguably one of the more radical concepts we want to explore and we may well go out to seek further proposals.’


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