• National Cancer Patient Experience Survey shows CCGs where patients reported most appointments before being referred to hospital
  • Eleven per cent of Brent cancer patients reported five or more attendances before being referred
  • One-in-six Herefordshire cancer patients reported three or four appointments before referral

One London borough has nearly double the national average rate on an indicator that general practice is missing the early signs of cancer.

Six per cent of respondents to the latest National Cancer Patient Experience Survey said they saw their GP five times or more before being told they needed to go to hospital – but in Brent, north west London, that figure was 11 per cent.

The next highest proportion of patients saying it had taken five or more visits to be sent to hospital were in Lambeth Clinical Commissioning Group, south London, with 9.8 per cent.

The 2018 data is based on answers from 73,817 cancer patients about their care, with 43 per cent nationally saying they saw their GP once about health problems caused by the cancer before being told to go to hospital.

Nationally, 11 per cent of patients saw their GP three or four times before referral. 

However, practices within Herefordshire CCG in the West Midlands had a performance of 16.2 per cent on this measure – the highest in the country.

Three north west London CCGs, including Brent, had a score of 13.4 or more per cent on this measure.

A Herefordshire CCG spokeswoman pointed out nearly half of the respondents had been referred after only one visit to their GP.

However, she said in a statement: “We are working with our primary care colleagues to ensure timely referrals and work is being undertaken across Herefordshire and Worcestershire [Sustainability and Transformation Partnership] to improve education and training to primary care, specifically in relation to identifying signs and symptoms of suspected cancer and improving access to primary care testing.”

The North West London Collaboration of CCGs said “patient journeys were unique as there are many combinations of tumour sites and stages of cancer at diagnosis” and it would therefore not comment on what are individual circumstances.

A spokeswoman said: “As a local NHS region we have good cancer results; we have achieved the highest one-year survival nationally and the fourth highest five-year survival nationally. Our emergency presentation rates, where patients are diagnosed in A&E are the second lowest nationally.

“We consistently meet the target for treatment within 62 days, and our Royal Marsden Partners Cancer Alliance partners are the only alliance to meet the 85 per cent standard for the 62-day targets.”

Lagging behind

The news comes as a study published in the Lancet found Britain’s cancer survival rates continued to lag behind other rich nations on many measures.

The research compared outcomes from 1995 to 2014 in the UK, Australia, Canada, Denmark, New Zealand, Norway and Ireland. It found, while results had significantly  improved, Britain “has not yet caught up with the other countries”.

NHS England claimed the study, from the International Cancer Benchmarking Partnership, run by Cancer Research UK, was “out of date” as the end of the period studied was five years ago.

A spokeswoman said Office for National Statistics data showed an increase from 71.5 per cent to 72.8 per cent in one-year survival from 2014 to 2016. The most recent Public Health England data on cancer survival is for 2014.

NHSE said in a statement: “The NHS long-term plan will build on this progress by ramping up action to spot more cancers at the earliest possible stage when the chance of survival is higher, saving tens of thousands more lives every year.”

But Cancer Research UK said this was not likely to happen unless workforce shortages in diagnostics were addressed.

HSJ National Cancer Forum

The HSJ National Cancer Forum takes place on 18 March 2020 at the Park Plaza Victoria in London. Taking place over one day, the forum will bring together the cancer community to discuss national policy and how to deliver the long-term plan at a local level. The event is free to attend for the relevant audience from the NHS. By attending you will gain clarity on and hear analysis of national policy from those responsible for shaping it, and understand how to implement it in your area. You will also explore the future of cancer care, and the innovations along the whole pathway.

Register your interest