The data suggests that, while NHS patients given an urgent referral will wait a similar amount of time to see a specialist as private patients, those given a routine referral will wait longer. Six per cent of private patients waited no time between getting a referral and seeing a specialist compared to 1% of urgently and routinely referred NHS patients (both 1%). However, while around 70% of both private and urgently-referred NHS patients waited less than two weeks, just 12.8% of routine patients saw a specialist within this time. Over half of these routinely referred patients had to wait more than a month, compared to just 8% of private patients.
For common cancers, the difference between a private and NHS referral in terms of getting a quick diagnosis may not be great. Overall, more than half of cancer patients are given an urgent referral, rising to three-quarters of breast cancer patients, half of colorectal and lung cancer patients and 55% of prostate cancer patients.
However, a much lower proportion of patients with rarer cancers get an urgent (two-week) referral – 12.8% of brain cancer patients, 22% of leukaemia patients and 35% of liver cancer patients. These patients are much more likely to be diagnosed as an emergency – including 39% of brain cancer patients – where outcomes are likely to be worse.
The Government’s current cancer strategy states that GPs need to be able to directly access tests for patients whose symptoms do not warrant an urgent referral but require further investigation, including MRI for brain cancer diagnosis and ultrasound for ovarian cancer.
In 6% of cases in this study, the GP believed that better access to investigations would have reduced delay in diagnosis, rising to 20% for brain cancer, where GPs want better access to CT and MRI scanning.
The audit was conducted as part of the National Awareness and Early Diagnosis Initiative (NAEDI), which was established to enable the NHS to better understand and address the reasons for later diagnosis of cancer in England, believed to be a major cause of poorer survival outcomes compared to other countries.