Bradford GP practices pilot new fast-track cancer referral

A team of Bradford GPs has won funding to pilot a new fast-track referral system for patients who have symptoms suggesting problems with their gullet or stomach, which could be a sign of a developing cancer.

The Westcliffe Group of practices, part of NHS Bradford Districts Clinical Commissioning Group (CCG), has developed an innovative new way of fast-tracking patients for tests and diagnosis if they have any problems that could be linked to upper gastrointestinal (GI) cancer.

Upper GI cancer can affect the oesophagus, stomach, liver, pancreas, gall bladder or bile ducts, and, as with all types of cancer, people stand a much better chance of survival with early diagnosis and treatment.

The most common sign of cancer of the oesophagus is difficulty swallowing, with a feeling that food is getting stuck on its way to the stomach. Other symptoms include abdominal pain or discomfort, vomiting, hoarseness of voice and a long-lasting cough.

The Health Foundation, an independent healthcare charity, is supporting the practices with funding to pilot the online referral system with their 50,000 registered patients. If successful, it could be rolled out across Bradford or other CCG areas.

Patients will be able to use the system to be referred directly for appropriate investigations and tests or to a specialist clinic, without waiting to get a GP appointment first. They will answer a series of questions to be triaged electronically: either being asked to go for tests; such as an endoscopy or ultrasound scan, and having a choice of which clinic to attend, or to see their GP for a routine appointment.

This means that patients will avoid delays in getting tests and a diagnosis – so, if needed, they get treatment for their cancer as soon as possible. The pathways of care being directed by the referral system are underpinned by the National Institute of Health and Care Excellence (NICE) in its guideline: ‘Suspected Cancer: recognition and referral’.

Dr Pam Rawal, a GP at Cowgill Surgery who has a special interest in gastroenterology, has led the team developing the online referral form. She believes it will help more patients get fast access to the right care, especially if they have early stage cancer.

“We are always looking at ways to improve patient care and especially for people who may have symptoms of cancer,” said Dr Rawal. “We are delighted to have the opportunity to change how we can offer healthcare services that will help us beat cancer through earlier diagnosis.

“Many patients over 55 have problems swallowing, which could be a symptom of oesophageal cancer or something less serious like an ulcer, but they put off going to the GP or struggle to get an appointment.

“Having the online referral form saves a lot of time and can get a patient into the system very quickly, so they can find out what’s causing their problem and get fast treatment. Thankfully, many patients’ symptoms won’t mean they have cancer, but for the few that do the new e-form will speed up their diagnosis and could lead to much improved outcomes.”

The practices are testing out the online form with their patient groups, informing all their staff about the new system so they can tell patients and promoting it in waiting rooms and on the practices’ websites.

The Westcliffe Group of practices includes Westcliffe Medical Centre, Shipley; The Willows Medical Centre, Queensbury; Cowgill Surgery, Clayton; and Thornton and Denholme Medical Practice;

The GP team has worked with Oberoi Consulting, which has developed the IT behind the innovation.

  • The Health Foundation selected the Westcliffe Group to be part of its £1.5m innovation programme: Innovating for Improvement. This, the third round of the programme, is supporting 20 care projects in the UK with the aim of improving healthcare delivery and the way people manage their own healthcare by testing and developing innovative ideas and putting them into practice.