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GP continuity of care could improve cancer survival

Seeing the same GP and longer GP consultations may reduce delays in diagnosis, primary care experts say

Ingrid Torjesen

Thursday, 10 October 2013

Delays in cancer diagnosis could be reduced if all patients saw the same GP with whom they build up a relationship over time, a team of primary care experts say in an essay in the Journal of the Royal Society of Medicine.

Late diagnosis is a major contributing factor to poor cancer survival rates in the UK and it has been suggested that over 10,000 deaths a year might be avoided if survival rates matched the best in Europe. Patients themselves may be a factor in delayed diagnosis by not recognising and seeking advice on warning symptoms, but clinician and health system related factors could also be contributing the authors of the essay say.

Improved continuity of care, together with longer consultations and better distribution of information to GPs about referral pathways or new services could have a wide reaching impact on the early diagnosis of cancer and survival, the authors argue. However, recent changes in the structure of the NHS and the continuing pressure on limited resources and increasing demand means this may be difficult to implement.

Lead author, Dr Thomas Round, clinical research fellow at King’s College London, said: “Early diagnosis is the result of the best interaction between patients and their GPs. Some of the interventions we are suggesting, such as longer GP consultation times, have been advocated by the Royal College of General Practitioners, and could be implemented at an individual GP and practice level. However, they would be difficult to implement given recent NHS reorganisation and constrained budgets, with primary care dealing with 90% of NHS patient encounters with less than 9% of the NHS budget.

Other suggestions made by the authors include patient access to their records and ultimately patient held records, which may improve continuity.

“If patients can access all the information about themselves, make appointments, order repeat prescriptions and access information and decision making tools, this could increase health literacy, improve concordance and accuracy in the records as well as a trusting adult-to-adult relationship that itself improves health and outcomes,” Dr Round said.

DOI: 10.1177/0141076813504744

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