Quality standard

Quality statement 1: Direct access to diagnostic tests

Quality statement

GPs have direct access to diagnostic endoscopy, ultrasound, MRI, X-ray and CT for people with suspected cancer.

Rationale

People who visit their GP with symptoms that may suggest cancer are sent for diagnostic tests to confirm or refute a cancer diagnosis. Enabling GPs to use direct access for specific tests is cost effective and will reduce the time to reach a diagnosis.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured and can be adapted and used flexibly.

Structure

Evidence of local arrangements to give GPs direct access to diagnostic endoscopy, ultrasound, MRI, X-ray and CT for people with suspected cancer.

Data source: Local data collection.

Outcome

a) Time to diagnostic test for suspected cancer.

Data source: Local data collection.

b) Time from presentation at GP to cancer diagnosis.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (primary care, secondary care and community imaging services) ensure that systems are in place for GPs to send people with suspected cancer directly for diagnostic endoscopy, ultrasound, MRI, X-ray or CT.

Healthcare professionals (GPs or practice nurses) send people with suspected cancer, when appropriate, directly for diagnostic tests such as endoscopy, ultrasound, MRI, X-ray or CT.

Commissioners (clinical commissioning groups and NHS England) ensure services use direct access pathways to send people with suspected cancer directly to diagnostic endoscopy, ultrasound, MRI, X-ray or CT.

People with symptoms that may suggest cancer sometimes need a test, such as an X-ray or scan. These tests will find out whether or not the person's symptoms are caused by cancer. People who are sent for these tests directly by their GP will find out whether or not they have cancer faster than if they were referred using a cancer pathway.

Source guidance

Suspected cancer: recognition and referral. NICE guideline NG12 (2015, updated 2021), recommendations 1.2.1 and 1.2.7

Definitions of terms used in this quality statement

Direct access

When a person is referred directly by their GP for a test in a specialist service and the GP retains responsibility for the person's care, including following up and acting on the results. [Adapted from NICE's guideline on suspected cancer]