Dr Laurence Buckman said paperwork and NHS reogranisations does not help GPs to get on with their jobs
Cancer patients face a lottery over how quickly their GP will send them to a specialist or whether they will be referred at all, a report warned yesterday.
It shows a 35-fold variation in referral rates nationwide, with some patients sent to hospital unnecessarily while others never get to see a consultant at all.
The study by The King’s Fund think-tank says most GPs refer patients within the two-week deadline for suspected cancer.
But it also found many late referrals, particularly for certain cancers.
One in three patients with stomach or oesophageal cancer requiring urgent investigation were given a non-urgent referral instead, delaying their treatment.
The report said:‘An important component of cancer referral relates to the assessment of urgency, and there is growing evidence questioning GPs’ ability to do this accurately.’
Britain has one of the lowest cancer survival rates in Europe, partly due to late diagnosis.
Evidence from cancer charities shows a quarter of cancer sufferers are being sent away by family doctors who dismiss their early warning signs as minor ailments. The King’s Fund report is based on the findings of an inquiry into general practice started by the think-tank in 2009.
An analysis of GP referral rates for suspected cancers from 51 practices in South London found wide variations. Referral rates for seeing a specialist within two weeks ranged from 0.7 to 25 per 1,000 patients, representing a 35-fold difference.
The percentage of diagnoses of cancer from these referrals also ranged from zero to 24 per cent.
Some patients are sent to hospital unnecessarily while others never see a consultant at all
The think-tank said that if the findings were replicated across England, practices that sent too many patients to see specialists– leading to a low rate of diagnosis because not many of them actually had the illness– risked creating anxiety and overburdening services.
On the other hand, GPs who did not refer enough suspected cases, which led to a high rate of diagnosis, could be leaving out patients with the disease who needed prompt specialist treatment.
Dr Laurence Buckman, of the British Medical Association’s GPs committee, said:‘Given the increased intensity and complexity of general practice work, GPs need time off the treadmill so they can look critically at what they do and make improvements.
‘Reducing bureaucracy would help them, as would stopping the constant reorganisations within the NHS. Where GPs fall short, they need to be helped to see where they can make their service better and given the time, resources and staff support to do this.’
Chris Ham, chief executive of The King’s Fund, said:‘Although general practice in this country remains the envy of the world, there is no room for complacency. Too many GPs remain unaware of significant variations in performance and do not give priority to improving quality.’
Health minister Lord Howe said:‘We have a very strong system of general practice, but there is too much variation in quality.’
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