Hospitals ‘are refusing vital cancer scans’

Tests rationed to cut costs, claim GPs

THOUSANDS of cancer patients are being diagnosed late because hospitals are refusing to carry out urgent tests.

A third of GPs say patients they have referred to specialists for vital X-rays or scans have been sent back or downgraded in importance and made to wait weeks longer.

Hospital staff are suspected of trying to ration tests as they are under pressure to meet waiting time targets and cut costs.

The NHS is struggling to cope with the soaring numbers of cancer patients – and the latest figures show there are now 800 new cases a day.

Britain’s cancer survival rates are also among the worst in Western Europe, and experts say tumours are not being detected early enough.

At least one unidentified hospital has already banned GPs from sending patients for urgent tests within two weeks to ‘ease pressure’ on busy clinics.

And managers at two health trusts have resorted to bribing doctors with cash rewards if they reduce the number of referrals.

GPs who suspect a patient has cancer are meant to refer them directly to a consultant, who arranges an urgent X-ray, scan or ultrasound within two weeks.

But 31 per cent of 484 family doctors surveyed by GP magazine said their patients had been ‘bounced back’ or ‘downgraded’ to have a routine test with a much longer wait.

A fifth of GPs said their patients were later found to have cancer, raising concerns the diagnosis was delayed by hospital staff.

Some were told by consultants or managers that a patient had been sent ‘ inappropriately’ because they did not have the correct symptoms.

One GP said at least two of his patients had died because they were ‘bounced back’ and the cancer detected too late.

Another said a patient with suspected bowel cancer had been refused a scan, given a routine outpatient appointment and sent away with iron tablets.

Hospitals must ensure that 93 per cent of patients with suspected cancer are offered an urgent scan within two weeks. If they miss this target they are fined thousands of pounds per patient.

But some GPs said hospitals were gaming the system by offering patients appointments with nurses – to ensure they still met the two-week target.

However, these nurses do not carry out the scans requested by the family doctor. Instead, they carry out other procedures before sending the patient back to the GP, saying they are ‘normal’.

One GP said hospital staff frequently denied receiving urgent referral letters in a ruse to avoid patients clogging up clinics. Another family doctor said he had been sent a letter from managers at his local hospital telling him not to refer any patients for urgent cancer tests.

A Freedom of Information request in October revealed that at least two NHS trusts were paying GPs to slash referrals – including for urgent cancer tests. In the North East Lincolnshire Clinical Commissioning Group, practices were offered an extra £6,000 for reducing the number of outpatient appointments.

And surgeries in the Lambeth Clinical Commissioning Group in South London were also told they would receive extra funding for slashing referrals.

Dr Rosie Loftus, of Macmillan Cancer Support, said: ‘ It is extremely worrying that cancer patients are potentially being diagnosed late because of urgent GP referrals being downgraded.

‘GPs need to be supported to trust their clinical judgment. If this isn’t the case it’s a clear sign of the pressures within the NHS.’

An NHS England spokesman said hospitals must follow official guidelines to ensure patients are cared for ‘swiftly’ and in line with ‘evidence-based practice’.

‘Extremely worrying’