GPs’ advice service is causing cancer diagnoses to be missed, inquiry finds

A recent inquiry has found that advice and guidance services for doctors in England may be causing missed or delayed cancer diagnoses. The Health Services Safety Investigations Body (HSSIB) discovered that the system, originally designed to decrease unnecessary hospital visits, instead contributed to near misses and patient harm when poorly implemented or monitored.

The report states that delays or missed diagnoses, as well as disruptions to care and treatment, have resulted in patient harm. Although the A+G service improved communication between GPs and consultants, evidence showed it led to delays in cancer diagnoses when GPs sought specialist input for suspected cases. Gaps in implementation, such as requiring GP use of A+G instead of direct referrals or rejected referrals despite concerns, were also identified.

The HSSIB recommends NHS England and the Department of Health and Social Care to swiftly evaluate A+G services to address resource gaps, training needs, and weaknesses in reporting patient safety incidents. Dr. Nick Woodier, a senior safety investigator, noted that A+G services benefit many patients, but serious concerns and evidence of harm exist when implementation is inadequate.

NHS England acknowledged the positive impact of A+G but stressed the need for further improvements, including clear guidance and practical tools for GPs and hospitals. The British Medical Association highlighted the concerns of GPs regarding the system, with 25% of patient referrals being rejected and 36% of A+G asking GPs to perform tasks outside their scope.

Dr. Clare Bannon, chair of the GPs' committee at the British Medical Association, emphasized that the report vindicates GPs' concerns, revealing patient harm due to the rushed and inconsistent application of the A+G process.