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GP cancer scan restrictions exposed

Half of GPs are prevented from directly referring suspected bowel or brain cancer patients for scans, an investigation has found.

Patients face a "postcode lottery" of services due to restrictions imposed by some clinical commissioning groups (CCGs), according to GP magazine, which carried out the study.

Freedom of Information (FOI) responses from 182 CCGs, which organise the delivery of NHS services in England, found 49% barred GPs from directly accessing MRI scans for suspected brain cancer patients.

Meanwhile, 50% of CCGs said they did not commission direct access to flexible sigmoidoscopy tests in cases of suspected bowel cancer, the study found.

GP leaders warned that forcing doctors to use alternative routes such as a two-week urgent referral pathway was "unnecessary" and led to longer waiting times and greater overall costs.

According to the study, a quarter (25%) of CCGs said they did not allow GPs direct access to chest X-rays for suspected lung cancer cases and 27% did not commission access to ultrasound scans for ovarian cancer.

In total, 22% of CCGs did not commission direct access to any of the four diagnostic tests, according to GP magazine.

Dr Richard Vautrey, deputy chairman of the General Practitioners Committee (GPC), said the figures showed "the rhetoric doesn't match the reality".

He told GP magazine: "It's frustrating.

"There's been an increase in pressure on what should be done within the community, but for GPs to be empowered to be able to do that, we need the support services and particularly access to diagnostics.

"There's no real reason other than cost that prohibits access to services.

"But in many cases, it actually reduces costs overall if you enable GPs to have greater access to these types of services, because they can avoid making potentially unnecessary referrals."

A third of CCGs said they commissioned all four of the cancer diagnostic tests, according to GP magazine, while 7% said they were considering allowing access to tests in the next year which they did not already commission.

A Department of Health (DoH) spokesman said: "W e have already invested £450 million in early diagnosis of cancer, and, as the Office for National Statistics says, survival rates are at record highs.

"Direct GP access to diagnostic tests is one pathway that helps with this, but there has also been a 50% increase in GPs' use of the urgent suspected cancer referral pathway over the last four years.

"GPs directly requested over a quarter of all tests that may have been used to diagnose cancer in June 2014 and we delivered a record 1.6 million diagnostic tests in July 2014, compared with 1.2 million in April 2010."

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