43% of cancer patients saw GP at least twice before getting tests, report says

More than four in 10 people who are eventually diagnosed with cancer have to see their GP at least twice before being referred for tests, a new report shows.

The NHS National Cancer Patient Experience Survey, completed by 73,817 people with cancer, found thousands had to make repeat visits to family doctors before eventually being sent for tests.

Of 51,973 people who saw their GP with symptoms, 15% had to go back three or four times before they were eventually referred to hospital for further investigation.

Almost one in 10 (8%) saw their GP five or more times while a fifth (20%) went to their GP twice.

Overall, 43% of people who saw a GP with symptoms had to go at least twice before being referred for tests.

The survey, carried out on behalf of NHS England, found that while most people rate their overall experience of NHS cancer care highly, some areas performed significantly worse in 2018 than in 2017.

When asked how they felt about the length of time they had to wait before their first appointment with a hospital doctor, 83.6% of patients said they were seen as soon as they thought was necessary – “significantly lower” than the 84.2% in 2017, the report said.

When asked to rate the administration of their care, such as getting letters at the right time and doctors having the right notes and test results, 88.5% of patients said that this was “good” or “very good” – again “significantly lower” than the 89.6% score in 2017.

Just 35% of patients received a care plan setting out their treatment and goals.

Some 86.7% of patients said they waited about the right length of time for their tests to be done, down on the 87.3%  the year before.

But a slightly higher proportion of people than the previous year said there were always enough nurses on duty during their treatment, and there were also higher scores for being given information about side-effects, pain control and privacy.

Overall, asked to rate their care on a scale of zero (very poor) to 10 (very good), NHS patients gave an average rating of 8.8.

Ruth May, Chief Nursing Officer for England, said: “Patients’ satisfaction with their cancer care remains at a record high with nine out of 10 patients happy with the care and support they’ve received, which is testament to the hard work and compassion of NHS staff.

“This is despite record numbers getting checked for cancer and surviving it, with 2.2 million getting checked for cancer last year.

“The NHS Long Term Plan will ensure that even more people receive earlier cancer checks alongside the best possible care and lifesaving new treatments.”

Dr Richard Roope, clinical lead for cancer for the Royal College of GPs, said: “GPs understand the importance of spotting symptoms of cancer, and referring appropriately – and actually research has shown that emergency presentations of cancer are at an all-time low, suggesting that GPs are identifying those patients who might have cancer and referring more appropriately than ever before, despite the increased pressures they face.

“It is notoriously difficult to diagnose many cancers in primary care, particularly in the early stages of the disease, often there are either no symptoms or they might be vague and indicative of other, more common conditions.

“GPs and our teams also need to be mindful of onward pressures in secondary care, and often come in for criticism for over-referral, as well as not referring enough.

“The most effective way to address this is to give GPs and our teams in primary care better access to the appropriate diagnostic tools in the community, and the training to use them.”

Macmillan Cancer Support’s director of policy Moira Fraser-Pearce said: “We know how important it is to be diagnosed as early as possible, and for GPs to refer people for further investigation as soon as is appropriate.

“This is a complex process where there are often many possible causes for symptoms, and GPs are providing the best care they can faced with high workloads and dwindling numbers of NHS staff.

“This is a timely reminder that Government must tackle the staffing crisis with a fully funded plan to grow and sustain the NHS and social care workforce.

“Anything less fails people living with cancer and the professionals that support them.”