Women with breast cancer symptoms can now see specialist directly

Women with ‘worrying’ lumps in their breasts will be able to refer themselves directly to a specialist in an effort to improve cancer outcomes.

Wes Streeting said the move will have the added benefit of freeing-up GP appointments for other patients and could soon be expanded to more conditions.

The health secretary made the announcement at the Royal College of GPs annual conference in Liverpool today, where he also vowed to ‘bulldoze bureaucracy and cut red tape’ so doctors could spend more time treating and less time form-filling.

Mr Streeting told delegates he knew how ‘intolerable’ it is for GPs who spend a fifth of their time dealing with admin, with some doctors forced to complete more than 150 forms when referring patients to a consultant.

He launched a ‘red-tape challenge’, encouraging doctors to let officials know where time-savings could be made and said he and Amanda Pritchard, chief executive of NHS England, would review them.

Mr Streeting added: 'The other frustration I hear from staff and patients alike are the pointless appointments you are forced to hold and patients are forced to attend.

'You did not go through five years of medical school, plus five years of training, to tick boxes.

'So, where there are appointments that can be cut out - with patients seen by specialists faster and GPs time freed up to do what only GPs can do - we will act.

'Starting in November, 111 Online, which is available through the NHS App, will pilot directly referring women with a worrying lump to a breast clinic.

'That means faster diagnosis for cancer patients and more GP appointments freed up. Better for patients and better for GPs.

'And I suspect there are other cases that come across your desks every week where a patient is being passed to you by someone else in the NHS to refer them on to someone else in the NHS too.

'It is a waste of everyone's time - including yours.

'And where you give us examples of patient pathways that can be simplified for appropriate patient self referral - or direct referral by other NHS services - to save your time, we will act.'

FIVE LESSER-KNOWN SIGNS OF BREAST CANCER 

• Retracted, inverted or downward-pointing nipple (31%)
• Breast puckering (an indentation that appears when you raise your arms) (39%)
• Loss of feeling in part of the breast (41%)
• Pitting/thickening of the skin on the breast (45%)
• Nipple discharge (51%)

Percentage in brackets refer to the proportion of people who knew they were a sign of breast cancer in a study of 1,000 adults by researchers at Ohio State University. 

Breast cancer is the most common form of cancer in women in the UK, with around 57,000 new cases diagnosed each year.

Around 85 per cent of women with the disease will survive for five years or more - but the odds of dying increase the later it is discovered.

The pilot will see women with ‘red flag symptoms’ being referred to breast diagnostic clinics without the need to see a GP first.

It will launch in Somerset before being rolled out nationwide, if it proves successful.

Mr Streeting also urged GPs to end their industrial action, which has seen some halve the number of appointments they are offering to just 25 per day.

He warned the restrictions ‘punish’ patients and pile more pressure on to other parts of the NHS.

The Government will work to introduce single patient records, which can be accessed by medical staff in GP surgeries and hospitals, he revealed.

Currently, records are not routinely shared between primary and secondary care, impairing care and forcing patients to repeat their medical histories to clinicians when moving between organisations.

Ministers also want to make it easier for researchers to use patients’ medical records for studies, subject to patient consent and adequate data security. 

Mr Streeting said: ‘We need to work together to create a single patient record, owned by the patient, shared across the system so that every part of the NHS has a full picture of the patient.

‘This applies as much to research as to care. The two go hand in hand.

‘World-leading studies like the UK Biobank, Genomics England, and Our Future Health are building up incredibly detailed profiles of our nation’s health.

‘Patients have given their consent for their data to be shared with these studies. But we still see, far too often, that this data is not shared according to patients’ wishes.

‘That’s why I am directing NHS England to take away this burden from you.

‘Just like they did during the pandemic, if a patient explicitly consents to sharing their data with a study, NHS England will take responsibly for making this happen. In return, we will demand the highest standards of data security.’

Sally Kum, associate director of nursing and health information at Breast Cancer Now, said: 'Two thirds of breast cancers in England are detected when women find a new or unusual breast change and get this checked out by a GP – crucially, the earlier breast cancer is diagnosed the better the chance of treatment being successful, and lives being saved from this disease.

 'We tirelessly advocate for timely access to a breast cancer diagnosis and treatment, as we know it can make all the difference. As such, we welcome the Government’s focus on ensuring more people get referred to a specialist faster when they find a breast change.

'We look forward to seeing the results and impact of this pilot scheme, critical to its sustainability and success will be its consideration of the capacity and resource needs of 111 in delivering the service.

'Alongside this we continue to encourage all women to ‘get to know their normal’ by familiarising themselves with the signs and symptoms of breast cancer and prioritising regular breast checking and reporting any new or unusual breast changes to a GP.'

Dr Vin Diwakar, NHS medical director for transformation, said: 'New technology has the power to transform how we manage our healthcare – we’re excited to be piloting in Somerset whether 111 online could refer women with red flag symptoms for breast cancer checks without the need to see a GP, and this is just the start of our plans to bring NHS services to patients through the app.

'Our ambition is to create a single patient record so that health staff can see your medical history at the touch of the button without you needing it to repeat it again and again, and we want to create a future where the data that the NHS holds can be used to save lives by predicting who is most at risk of developing cancer or other diseases, and taking action to prevent them.'

There are concerns that allowing patients to refer themselves to specialists without the need to see a GP could place additional strain on a system that is already under pressure.

The Society of Radiographers warned earlier this year that a lack of mammographers is leading to late diagnoses and treatment delays, which can reduce survival chances.

It said the mammography workforce in the NHS in England has reached 'critical levels', with a 19.8 per cent vacancy rate among symptomatic mammographers, who scan women who find a lump in their breast or those who have a family history of breast cancer.

Professor Kamila Hawthorne, Chair of the Royal College of GPs, said: 'The NHS breast screening programme has potentially saved thousands of lives - and as a College we support evidence-based screening programmes that are approved by the National Screening Programme or NICE.

'Initiatives that could increase uptake of screening within the programme are welcome and should be explored, as well as how we can use technology to safely support access to screening.'

However, she added: 'It’s good to hear that this initiative will be piloted first, as, like any new initiative, it will need to be rigorously evaluated in terms of safety and effectiveness before wider roll out.’