Competition between GP surgeries could diagnose cancers earlier

Encouraging doctors to COMPETE to refer more patients for cancer testing ‘could save thousands lives’

  • Letters telling GPs other surgeries refer more patients could spur them on
  • Below-average referrers sent 10 per cent more patients for tests after being told
  • Experts say UK cancer survival rates are held back because of late diagnoses

Encouraging doctors to compete to refer more patients for cancer testing could save lives, according to experts.

A study suggests 2,500 extra cancers could be spotted earlier each year if GPs with low referral rates were sent letters telling them others are referring more patients.

Cancer survival is believed to be held back in the UK in comparison to other Western nations because we are not as quick to diagnose the diseases.

But a healthy rivalry between doctors could spur them on to boost the number of patients they refer for hospital tests by up to 20 per cent, experts say.

Doctors are likely to send more patients for cancer testing if they are sent a letter telling them other surgeries nearby have higher referral rates, a study by the Government’s Behavioural Insights Team discovered in a survey of 244 surgeries in Manchester (stock image)

Research carried out by the Government’s Behavioural Insights Team tested the theory by sending letters to GP surgeries in Manchester.

It targeted 244 surgeries with cancer test referral rates which were below average, The Times reports.

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In the letters, the surgeries were told their referrals were below average and that other clinics nearby were sending more patients for tests.

As a result, those sending the fewest patients upped their game by as much as 20 per cent, compared with surgeries which weren’t sent letters.


Half of GPs have been blocked from sending patients for urgent cancer scans, a survey found last year.

Family doctors are meant to refer any patient suspected of having cancer for a hospital test within two weeks.

But 46 per cent of GPs said at least one of their referrals had been blocked or downgraded by cost-cutting staff in 2017-18.

This leads to patients waiting longer to be diagnosed with cancer and offered life-saving treatment.

One GP said he had repeatedly tried to refer a child for urgent hospital tests for blood cancer, but was turned down by hospital doctors.

Eventually the tests were carried out and the child was diagnosed with advanced lymphoma – blood cancer.

The survey involved 507 GPs and was carried out by GP Online, a website for family doctors. 

The results showed a rise from 31 per cent of doctors giving the same answers in the previous year. 

The team said doctors may be more likely to respond to peer pressure than being told off by authority figures.

‘Just browbeating people or just giving information, that’s not effective in changing behaviour [but] social norms are a very, very powerful factor,’ the Behavioural Insights Team’s Felicity Algate told The Times.

But she added there still needed to be measures to avoid sending too many patients for unnecessary testing.

‘There are conflicting messages because there is quite strong pressure not to refer too many people,’ Ms Algate added.

Health chiefs are reportedly considering implementing the letter-sending policy in the NHS.

Last year, an official report – produced by former National Cancer Director, Sir Mike Richards – said GPs sending too few patients for tests was one explanation for late diagnosis rates in the UK.

Referral rates rose by 10 per cent on average among the 30 per cent of surgeries with the lowest number of patients being sent for tests.

But the Royal College of GPs – which represents NHS and private doctors around the UK – had concerns about piling pressure on doctors to send people to hospital.

‘When some cancers are in the early stages they display similar symptoms to many much more common illnesses that must first be ruled out,’ said RCGP chair Helen Stokes-Lampard.

‘The real problem lies with the lack of resources, including diagnostic tests in the community.’

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