New rule for women who find a lump in their breast

Two thirds of breast cancers in England are detected when women find a new or unusual breast change

Women with “worrying” lumps in their breasts will be referred directly to specialist clinics through the NHS app as part of plans to slash paperwork for GPs. The move was announced by Health Secretary Wes Streeting in an address to family doctors at the Royal College of GPs (RCGP) annual conference in Liverpool on Friday.

The pilot scheme, which will begin next month in Somerset, forms part of Government plans to get patients referred to specialists faster. Speaking on cutting red tape, Mr Streeting told delegates: “The other frustration I hear from staff and patients alike are pointless appointments you’re forced to hold and patients are forced to attend.

“You didn’t 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.”

The pilot scheme will be evaluated before further roll-out is considered, according to the Department of Health and Social Care. Professor Kamila Hawthorne, chair of the RCGP, said: “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.

“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.”

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.”

Mr Streeting also announced plans to slash the amount of paperwork GPs needed to complete to refer patients. He added: “When I spend time shadowing GPs, one of the things they’ve been dying to show me is the sheer amount of paperwork you are required to fill in to refer a patient.

“I was genuinely stunned to hear about one practice that has to complete more than 150 different forms to refer patients into secondary care services. Practices spend as much as 20% of their time on admin and work created by poor communications with secondary care. This is intolerable, that time should be spent with patients.”

The comments follow the launch of the so-called Red Tape Challenge which aims to tackle bureaucracy and free up more time for patients. In the coming months, officials will ask GPs, hospitals and integrated care boards (ICBs) what changes they would like to see, with the information fed back to a group of doctors working in primary and secondary care.

The information will be passed to NHS England chief executive Amanda Pritchard in early 2025. After announcing these initiatives, Mr Streeting said: “It reflects the partnership I want to build with this profession.

“What I need from you in return is goodwill and the same team spirit.”

It comes after GP members of the British Medical Association (BMA) voted in favour of collective action in August. The union recommended 10 actions to surgeries – with practices able to choose how many they implement – including limiting the number of patients seen per day to 25 and potentially stopping work they are not formally contracted to do.

Mr Streeting said he was not “remotely surprised” by the ballot result, adding: “I know that after years of rising pressures, declining resources and worsening service of patients, you fear it’s your duty to sound the alarm. And trust me, you weren’t the only ones who wanted to punish the previous government.

“But the Conservatives got the kicking they well and truly deserved on July 4, capping appointments now will only punish patients and make the road to recovery steeper. So be in no doubt it is shutting the door on patients, their care will suffer, receptionists will bear the brunt of their frustration, and the rest of the NHS will be left to pick up the pieces.”

Prof Hawthorne told Mr Streeting: “With regards to the collective action, again, as you know, that’s the business of the union not the Royal College of GPs – although many members here will be members of the BMA. We want an urgent resolution to this so talk to them and get something sorted. Quickly.”