Cancer referrals are being rejected by hospitals, GPs warn

Suspected cancer patients are being refused hospital appointments despite being referred by GPs, it has emerged.

Family doctors working for one NHS trust in north east London claimed that hundreds of referrals had been rejected in recent weeks.

Many were for ultrasounds and chest X-rays and were sent via the two-week wait system, in which suspected cancer patients referred by GPs are seen within a fortnight.

A rejection letter sent from Whipps Cross hospital seen by Pulse magazine, said the referral had been “due to the Covid-19 pandemic”. 

It added: “Following triage by a consultant radiologist, your imaging request has been assessed as non-urgent and cancelled.”

One GP said their practice had been sent 44 referrals from departments within the Barts Health NHS Trust, which includes Whipps Cross, between the end of January and the end of April. 

Separately, a local lead GP said that between 400 and 500 rejections in total by radiology departments would be a “conservative” estimate.

Dr Jodie Moffat, head of early diagnosis at Cancer Research UK, said the problem was being replicated in pockets up and down the country.

“The NHS national cancer team is certainly alarmed that referrals are being turned away,” she said. “Patient lists should be managed to ensure that urgent referrals are not rejected.”

Dr Moffat said the issue highlighted the challenges faced by the NHS in getting back to business.

Dr Lance Saker, a London GP who works with Cancer Research UK, said NHS trusts were contacting hospitals in areas where referrals were being rejected to ask “what on Earth is going on?”

He added: “It varies depending on the area but is happening because people are deviating from national guidelines. Those appointments that have been rejected need to be followed up.”

Prof Karol Sikora, an oncologist and chief medical officer at Rutherford Health, said such decisions were almost certainly being made by hospital managers, rather than doctors.

“Managers are trying to make blanket decisions rather than on a case by case basis,” he said. “The NHS has issued a priority list for chemotherapy and radiotherapy patients but managers are viewing it differently. We need to get back to business.”

Data published by NHS England last week showed that one in four cancer patients were now waiting more than two months for treatment after an urgent GP referral.

Cancer waiting time targets were missed for seven of the nine key metrics in the three months to March 2020. Some 181,873 urgent cancer referrals were made by GPs in England in March 2020, down from 198,418 in March 2019.

A spokesperson for Barts Health NHS Trust insisted that urgent referrals were still going ahead and that it had found evidence of only two made under the two-week wait system that had been delayed. 

“Both of these patients have now been contacted so appropriate clinical action can be taken,” a spokesman said.

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