Breast cancer: Trial to diagnose patients more quickly

A trial to let women with worrying breast cancer symptoms book appointments directly with diagnostic clinics without going to see their GP first is being planned in one region of England.

Health Secretary Wes Streeting said the aim was to diagnose patients with cancer more quickly and free up more GP appointments.

The Royal College of GPs said the safety and effectiveness of the scheme would need to be rigorously evaluated.

The pilot will take place in Somerset and start in November.

Charity Breast Cancer Now said it welcomed the government’s focus on ensuring more people get referred to a specialist more quickly when they find a breast change.

GPs currently refer women of any age with worrying symptoms to a breast clinic.

Breast screening, which looks for hidden cancers, is offered every three years to women aged 50 to 71.

In the new trial, women contacting 111 online with worrying breast lumps will be referred directly to a specialist clinic through the NHS app, the government said.

The scheme will be evaluated before being rolled out to any other parts of the country, it added.

Speaking at a GPs’ conference in Liverpool, the health secretary said he had heard staff and patients alike complain about “pointless appointments”.

“You didn’t go through five years of medical school plus five years of training to tick boxes,” he told GPs.

“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.”

Mr Streeting said it was “a waste of everyone’s time” that patients were passed to GPs by someone else in the NHS only for them to be referred on to someone else in the NHS.

He also asked GPs not to “shut your doors to patients” and instead “work with us to rebuild the NHS together”.

Breast cancer is the most common cancer in the UK, Cancer Research UK says, with about 55,500 women and 370 men diagnosed in the UK each year.

One in seven women in the UK develop breast cancer during their lifetime, and it is more common in older women.

There are lots of factors which can increase someone’s risk of breast cancer – these include their age, family history and whether they smoke or are obese.

The NHS website says breast cancer symptoms can include:

• a lump, or swelling in your breast, chest or armpit
• a change in the skin of your breast, such as dimpling or redness
• a change in size or shape of one or both breasts
• nipple discharge (if you are not pregnant or breastfeeding), which may have blood in it
• a change in the shape or look of your nipple, such as it turning inwards or a rash on it
• pain in your breast or armpit which does not go away

Breast lumps are very common and can be caused by other conditions, NHS advice says, and having some of the symptoms does not definitely mean you have breast cancer.

In the UK, from the age of 50, women with no obvious symptoms are invited for a mammogram every three years to check for breast cancer, known as breast screening.

Professor Kamila Hawthorne, chair of the Royal College of GPs, said the NHS breast screening programme had “potentially saved thousands of lives”.

“As a college, we support evidence-based screening programmes that are approved by the National Screening Programme or NICE [healthcare watchdog],” she added.

Breast Cancer Now said it looked forward to seeing the results of the pilot scheme but said its success would also depend on whether NHS 111 had the resources to deliver the service.

Dr Vin Diwakar, NHS England medical director for transformation, said the breast cancer referral pilot was just the start of 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 to repeat it again and again,” he said.