GP referral to rapid diagnostic centres for non-specific cancer symptoms: a qualitative study.

Abstract

Background: Diagnosing cancer can be challenging, especially when patients present to General Practitioners (GPs) with serious, but nonspecific symptoms. Rapid Diagnostic Centres (RDCs) have been introduced in England as diagnostic pathways for patients with non-specific symptoms where cancer is suspected, but they do not meet existing cancer pathway criteria.

Aim: To investigate GP perspectives on referral to an RDC pathway for patients with non-specific symptoms and suspected cancer.

Design & setting: Semi-structured interviews with GPs within the catchment area of an acute NHS Trust METHOD: GP interviews focusing on experiences of using the RDC pathway. A thematic analysis was conducted on interview transcripts.

Results: GPs reported the RDC pathway as a game changer. It offered faster referral, reduced anxiety for GPs and patients, and reduced the need for GPs to 'game the system' when patients do not meet criteria for cancer-specific pathways. The narrative required on referral appeared to legitimise GP gut feelings and expertise. RDC results (if not cancer) gave GPs space to treat patients without concern of a missed cancer, while ensuring onward referral for those with cancer or other serious conditions. Some access barriers, especially related to travel and time, were identified especially for patients in rural areas.

Conclusion: This cancer pathway fills a referral gap for GPs and patients with non-specific potential cancer symptoms. It has an important signposting function, helping identify patients requiring treatment for cancer/other serious conditions, and others whose symptoms can be treated safely within primary care.