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BMA warns of danger of releasing ‘simplistic’ GP performance data after criticism over cancer referrals



The BMA has criticised the publication of ‘simplistic’ league tables of GP practice performance, after NHS England released a large tranche of outcomes data on the NHS Choices website for patients to scrutinise.

The tables include information on a total of 40 performance indicators that have not previously been available on the NHS Choices website, including practice-by-practice data on the proportion of cancer cases referred through the two-week wait pathway.

The latter statistic was attracted front-page coverage in the national media over the weekend, with the Daily Telegraph highlighting the fact that 59% of GP practices in England referred less than half of patients who went on to be diagnosed with cancer through the two-week pathway.

But GPC chair Dr Chaand Nagpaul said: ‘Simplistic league tables fail to show the complexity of this process. There are dangers of simply looking at headline figures without trying to understand the underlying causes, and we must remember that survival rates are not an indication of GP referral rates but much wider issues.’ 

He added: ‘The priority should be to understand what lessons can be learnt from the appropriate use of this data, and to identify better ways and systems to ensure patients with suspected cancers are picked up and treated as early as possible. It is important that this data is used not to unreasonably penalise GPs who are working hard to deliver consistently high standards of care to patients.’

In a letter to the Telegraph, RCGP clinical lead for cancer Professor Greg Rubin pointed out that many patients with cancer do not fit the criteria for urgent referral on the two-week-wait pathway when they present to their GP.

He said: ‘The highest achieving 10% of English practices now diagnose 70% of cancers in this way, likely to be near the realistic maximum. In recent years, efforts have been made by the NHS to work with GPs for earlier diagnosis. Urgent referrals for suspected cancer have increased, as has the proportion of cases then diagnosed.’

‘There is room for improvement and the differences between practices need continued action but your headline does not represent the facts.’

NHS England said the data had all previously already been in the public domain, via the Health and Social Care Information Centre and the GP Patient Survey. It insisted publishing the data was in the best interests of patients, ensuring accountability and transparency.

Dr Mike Bewick, deputy medical director at NHS England, said: ‘Making this data accessible and navigable helps patients understand how well their services are performing in the areas that matter to them most.’

‘This is a big step forward in transparency which will allow patients to take a full and active part in conversations about investment and improvement of their services, holding their providers and commissioners to account.’