03 August 2023

GPs to be given new powers to order tests in bid to ease NHS pressure

03 August 2023

GPs in England are to be given new powers to send their patients directly for checks for a range of respiratory and heart conditions, with up to one million people expected to benefit, NHS officials have announced.

Under the plans, GP practices will be able to directly order diagnostic checks for the likes of asthma, cardiovascular disease, heart failure and chronic obstructive pulmonary disease (COPD), referring patients to hospital or community diagnostic centres.

At the moment, GP practices can use clinical judgment on whether to refer a patient to a specialist or to send them straight for testing.

However, these powers vary in how they are applied due to a lack of resources or confidence.

The additional route to testing could reduce the need for specialist consultation and help diagnose and treat patients faster.

Our plans to enhance GP direct access will enable thousands more to get a vital diagnosis sooner

Dr Vin Diwakar, medical director for secondary care and transformation at NHS England, said: “We know how important it is to diagnose people with conditions like heart failure, COPD and asthma early, so they can get the treatment they need to manage their condition well, and to prevent more serious conditions or illness from developing.

“Our plans to enhance GP direct access will enable thousands more to get a vital diagnosis sooner, and by capitalising on the additional capacity provided by over 100 community diagnostic centres offering a ‘one stop shop’ for tests in the community, patients can benefit from convenient triaging and testing near their homes – and importantly avoid a hospital admission or trip to A&E.”

It is hoped the initiative will ease pressure on the health service in the run up to winter.

A similar system is already in place for cancer, which the NHS said has provided faster access for 80,000 patients who may not meet the National Institute for Health and Care Excellence (Nice) guidance threshold for an urgent referral.

Dr Diwakar added: “NHS staff are already making significant progress in reducing the Covid backlogs, and this efficient way of testing can potentially help us to reduce that even further.”

John Maingay, director of policy and influencing at the British Heart Foundation, said: “Many people are facing extremely long waits for heart care in England, and improving access to vital diagnostic tests could help more people receive a diagnosis of heart failure sooner.

“However, it’s important that there are enough NHS staff in place to deliver these tests and any treatment that patients may need in order to address the ever-growing backlog of time-critical heart care.”

For this initiative to be successful, it is vital that diagnostic capacity - both in terms of testing, and people to conduct and interpret tests - is sufficient

Professor Kamila Hawthorne, chair of the Royal College of GPs, said the organisation “has long been calling for better access to diagnostic tests and tools for GPs in the community”.

“GPs are highly trained to refer appropriately for specialist care and will only do so if they think it is in the best interests of their patients, but improved access to diagnostics will undoubtedly support them in this decision,” she added.

“For this initiative to be successful, it is vital that diagnostic capacity – both in terms of testing, and people to conduct and interpret tests – is sufficient, and that there is close co-ordination and clear communication between GP practices and secondary care teams.

“As we begin to think about how to ease pressures across the NHS over the coming winter months, we need to consider how to support general practice, which is working under intense workload and workforce pressures.

“GPs and our teams are already facing extraordinary pressures, delivering millions of appointments per month but with 900 fewer GPs compared to 2019, and this will only be exacerbated over the winter.”

Dr Kieran Sharrock, acting chair of the GP committee in England at the BMA, said: “While we acknowledge NHS England’s efforts to tackle winter pressure demands, the notion that it can do so by increasing the GP workload is frankly counteractive.

“These kinds of fast-tracked diagnostic referrals come with the expectation that additional work, such as performing complex investigations not part of a normal GP service, will be done prior to referral and NHSE has provided no details on how already overstretched GPs will undertake the extra work required.”

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