Cancer app developed by GPs being trialled by CCGs

A GP-developed app aiming to help GPs navigate the tests and urgent referrals necessary for patients presenting with cancer symptoms is being trialled by two CCGs | Pulse


C the Signs was co-founded by newly qualified GP Dr Bhavagaya Bakshi and fellow doctor Miles Payling and quickly checks symptoms of more than 200 cancers against multiple diagnostic referral pathways.

Last week the app won the People’s award at the Tech4Good awards and is now set to be trialled with GPs in the East of England to test its real world cost and clinical effectiveness.

Read the full news story here


GPs are failing people with eating disorders, says charity

Half of people with experience of condition rate GPs’ care as poor, survey finds | The Guardian


GPs are routinely failing to provide adequate care to patients with eating disorders, with one in three not referred for specialist assistance, a leading charity has warned.

Beat, the UK’s primary eating disorder charity, found that half of people with some experience of the condition rated GP care as “poor” or “very poor” and 30% were not referred to mental health services after their appointment.

The charity polled 1,700 people, the majority of whom had sought medical help for an eating disorder. Of the 1,267 who had gone to a GP for help, only 34% said they felt their doctor knew how to treat them.

Read the full news story here

Read the survey results from Beat here

NHS Digital has published guidance to help organisations deliver the NHS e-referrals service CQUIN requirements for 2017/18

The document will guide providers through the available data, and support them to make the necessary changes on their e-RS systems | NHS Digital

Image source: NHS Digital

The NHS e-Referral Service (e-RS) combines electronic booking with a choice of place, date and time for first outpatient appointments. Patients can arrange their hospital appointment with their GP during consultation, or independently either online or by telephone.

The purpose of this guidance is to:

  • Provide summary information to support provider organisations in submitting their plans in Quarter 1 and making the necessary changes on the NHS e-Referral Service to deliver the Quarter 2 to Quarter 4 CQUIN requirements, appending or signposting to appropriate detailed guidance.
  • Support providers and commissioners in understanding the data available within e-RS to help with the monitoring of delivery.

Read the full overview here

Read the full guidance here

Immediate chest X-ray for patients at risk of lung cancer presenting in primary care

Neal, R.D. et al. (2017) British Journal of Cancer. 116, pp. 293-302

AS0000184F07 Hospital doctors looking at X-ray of lungs
Image source: Anthea Sieveking – Wellcome Images // CC BY-NC-ND 4.0

Background: Achieving earlier stage diagnosis is one option for improving lung cancer outcomes in the United Kingdom. Patients with lung cancer typically present with symptoms to general practitioners several times before referral or investigation.

Conclusions: We have demonstrated the feasibility of individually randomising patients at higher risk of lung cancer, to a trial offering urgent investigation or usual care.

Read the full abstract here

Referral centres cause ‘dangerous’ NHS delays warns the BMA

NHS patients face “dangerous” treatment delays due to a 10-fold increase in “crude, expensive” referral management centres, doctors have warned | BBC News


The centres, sometimes run by private firms, vet GP referrals and decide if patients should receive hospital care. The British Medical Association (BMA) called them “inefficient” and a “block between the GP and patient treatment”. NHS Clinical Commissioners said “in many cases” the centres “provide a useful and effective role”.

All but 12 of the 209 Clinical Commissioning Groups (CCGs) in England responded to a BBC Freedom of Information (FoI) request. Sixty-one of them said they used some form of referral management centre. These centres were introduced in about 2003 and were designed to reduce NHS spending by limiting unnecessary referrals to hospital. However, one GP claimed cancer diagnoses were being delayed because of the extra bureaucracy. Since 2005 there has been a 10-fold increase in the use of referral centres.

A BBC investigation revealed there had been a rise in referrals being rejected for administrative, rather than clinical reasons, with delays due to administration queries rising from 28% in 2013-14 to 41% last year.

Read the full BBC news story here

Read the BMA news release here

Direct Referral of Adults with Hearing Difficulty to Audiology Services

New Direct Referral Guidance from BAA

Image source: BAA

This document is intended to guide the practice of those who make direct referral of adults with routine or complex hearing difficulties to Audiology services in the UK, primarily GPs.

Along with “Guidelines for Audiologists: Onward Referral of Adults with Hearing Difficulty Directly Referred to Audiology Services (2016) 1 ”, this document replaces the earlier guidelines (BAA 20092 , TTSA 19893,4 ) and has been approved by the Board of the British Academy of Audiology.

This document comprises a set of criteria which are contraindications for direct referral of adults with hearing difficulties to Audiology services for hearing assessment and rehabilitative treatment, either from Primary Care or via other intra-hospital Consultant pathways. Audiology services are expected to make reasonable efforts to make local GPs aware of this guidance and support their understanding of its application. The criteria have been written for all adults (age 18+), but local specifications regarding age range for direct referral should be adhered to.

A simple checklist has been included as an appendix, to summarise the criteria detailed in this document.

Read the full guidance here