GP access to appropriate diagnostic tests in the community is currently amongst the lowest in Europe, a report by The Health Foundation has found.
According to the report, while progress has been made on improving survival rates and care experience for people diagnosed with cancer since the introduction of a national cancer plan in 2000, England still had poorer survival rates than other European countries.
The NHS will need to invest significantly in boosting diagnostic equipment and workforce, the report says, noting that despite recent investment in equipment to treat cancer, the UK has “fallen far behind other countries” in the availability of diagnostic equipment per person, ranking 35th out of 37 countries for CT scanners, and 31st out of 36 for MRI scanners. There is also a shortage of staff to operate the machinery and report scan results, leading to delays in diagnosis and treatment.
The report highlights early diagnosis as key to improving outcomes and that a key factor in being able to diagnose patients in a timely way is having access to the right diagnostic tests, but that GP access to appropriate tests in the community isn't at the standard it should be.
Therefore, it called for greater support for GPs to refer more patients for urgent investigation, along with additional staff and equipment in hospitals to meet demand for referrals, noting that in the past efforts to encourage GPs to refer early for suspected cancer “have been met with resistance from commissioners under pressure to limit referrals, and by limited hospital capacity to meet demand for diagnostic tests such as endoscopy”.
The report estimates that 10,000 deaths could be prevented each year with better diagnosis, with a number of factors to blame. Also, one in five patients are still diagnosed in A&E units, which is associated with poorer outcomes as the disease is often more advanced at the time of diagnosis.
Despite this high number still being diagnosed at A&E level, Professor Helen Stokes-Lampard, chair of the Royal College of GPs notes that "in the last five years the proportion of cancers diagnosed as an emergency has dropped from 25% to 20%,” and a higher proportion of patients are also being diagnosed at an earlier stage of the disease.
However, she also warned “without access to the right tests, this is simply not sustainable. We desperately need for GPs and our teams to have better access to high quality diagnostic tools in the community and the appropriate training to use them.”