Variation in GP appointment rules linked to emergency presentations for cancer
GP practices that offer a routine GP appointment within 48 hours are less likely to have patients diagnosed with cancer for the first time via an emergency hospital admission, according to new research published by the British Journal of Cancer.
And the strongest link to why cancer was diagnosed for the first time through an unplanned hospital admission was to patients living in a deprived area.
Other characteristics of doctors’ surgeries where patients were more likely to be admitted as an emergency included having lower scores for quality (awarded through the National Quality and Outcomes Framework) and having no GPs who were trained in the UK. These links may be related to how practices are organised or the demographics of the areas they serve.
In the study, researchers from Imperial College London investigated the reasons why nearly a quarter of cancer patients are diagnosed with cancer through unplanned admissions to hospital – either through A&E or for being in hospital for another reason – rather than through planned appointments or two week wait appointment.
It looked at patients – across nearly 8,000 GP practices – who had a cancer admission for the first time between 2007 and 2010 and found that 22 per cent (139,351) were ‘unplanned’.
Dr Alex Bottle, study author from Imperial College London, said: “Our new research highlights just how crucial it is for cancer survival to have fast and easy access to primary care. GP practices where more patients are able to get an appointment with their GP within 48 hours were less likely to have patients turn up as emergency admissions to hospital. However, the biggest effect was associated with where the patient lived. Highly deprived areas were associated with an estimated 1,300 or more extra emergency admissions each year, compared with 300 extra for practice factors.
“Previous work has shown that nearly a quarter of cancer patients are first diagnosed through an emergency admission to hospital and that these patients have a poorer chance of surviving cancer. We wanted to find out if there was anything about these patients – their age, sex, ethnicity, where they lived, the type of cancer they had that meant they were more likely to first present with cancer as an emergency. We also wanted to see whether there were any characteristics of their GP practice that influenced unplanned cancer admissions.”
Sara Hiom, director of information at Cancer Research UK, said: “We know that in the UK we have an unacceptably high proportion of cancers being diagnosed via an emergency admission to hospital. This new research provides further pointers as to why these unplanned admissions happen. The important message remains to go to your GP without delay if you have persistent symptoms or unusual bodily changes that worry you.”
For media enquiries please contact the Cancer Research UK press office on 0203 469 8300 or, out-of-hours, the duty press officer on 07050 264 059.
Bottle, A et al. Association between patient and general practice characteristics and unplanned first-time admissions for cancer: observational study (2012), British Journal of Cancer, doi: 10.1038/bjc.2012.320