Reports in today’s newspapers suggest that some GP practices are being offered financial incentives not to refer suspected cancer patients to hospital for tests or appointments with a specialist.
The measure has reportedly been introduced by some clinical commissioning groups (CCGs) to encourage GP practices to investigate the patient themselves and do more monitoring in the first instance, rather than automatically refer patients.
Many blood cancer patients are already not being diagnosed and referred quickly enough, so it is obviously concerning that there could be an incentive being offered to some GPs not to refer patients. Blood cancer patients need to visit their GP more times on average than other cancer patients to get a referral, with their cluster of symptoms (typically tiredness, bruising, night sweats, headaches, or persistent infections) often unrecognised as serious in initial GP consultations.
Diana Jupp, Director of Patient Experience at Bloodwise, said: “The fact that blood cancer patients already struggle to be referred to a specialist, more so than other cancer patients, makes this news all the more concerning. We need to find out how widespread these practices are and investigate their impact.
“While there’s no reason to think GPs would not refer cases they suspect as cancer to a specialist immediately, any measures that may in any way incentivise GPs not to refer borderline cases to hospital are deeply concerning.
“Early referrals and testing in cases of suspected cancer need to be strongly encouraged - not discouraged. Signs and symptoms of blood cancer can be diverse, hard to spot and often dismissed as belonging to less serious conditions. We need to work with GPs to recognise these tell-tale groups of symptoms. Early referral can lead to better chances of survival in many cases.”
The 2014 National Cancer Patient Experience Survey found that 36% of blood cancer patients had to visit their GP three or more times before getting referred to hospital, compared to 25% of cancer patients overall. Nearly half (47%) of patients with myeloma, a cancer that is normally accompanied by debilitating bone damage, needed to see their GPs three or more times before a hospital referral.