Referral delays destroy cancer patients' confidence in healthcare system

Jul 31 2015

If it takes more than three trips to the GP to be referred for cancer tests, patients are more likely to be dissatisfied with their overall care, eroding confidence in the doctors and nurses who go on to treat and monitor them.

These worrying levels of dissatisfaction are based on further analysis of survey data from more than 70,000 cancer patients, by Cancer Research UK scientists at UCL (University College London) and the University of Cambridge, published today (Friday) in the European Journal of Cancer Care.

Of the nearly 60,000 survey respondents diagnosed through their GP, almost 13,300 (23 per cent) had been seen three or more times before being referred for cancer tests.

39 per cent of those who had experienced referral delays were dissatisfied with the support they received from their GP and nurses compared to 28 per cent of those referred after one or two GP visits.

Overall, patients who had seen their GP three or more times before being referred were more likely to report negative experiences across 10 of 12 different aspects of their care.

For example, 18 per cent of these patients were dissatisfied with the way they were told they had cancer, compared to 14 per cent among those who were referred after fewer visits.

And 40 per cent expressed dissatisfaction with how hospital staff and GPs had worked with each other to provide the best possible care, compared to 33 per cent among those referred promptly.

There was also an increase from 10 per cent to 12 per cent in those who suspected information may have been deliberately withheld from them during treatment. And a rise from 28 per cent to 32 per cent rise in patients who lacked confidence and trust in the ward nurses.

Study author Dr Georgios Lyratzopoulos, a Cancer Research UK scientist at UCL (University College London), said: "This research shows that first impressions go a long way in determining how cancer patients view their experience of cancer treatment. A negative experience of diagnosis can trigger loss of confidence in their care throughout the cancer journey.

"When they occur, diagnostic delays are largely due to cancer symptoms being extremely hard to distinguish from other diseases, combined with a lack of accurate and easy-to-use tests. New diagnostic tools to help doctors decide which patients need referring are vital to improve the care experience for even more cancer patients."

Dr Richard Roope, Cancer Research UK's GP expert, said: "It's important we now step up efforts to ensure potential cancer symptoms can be investigated promptly, such as through the new NICE referral guidelines launched last month to give GPs more freedom to quickly refer patients with worrying symptoms. This will hopefully contribute to improving the patient experience, one of the six strategic priorities recommended by the UK's Cancer Task Force last week."

Sara Hiom, director of early diagnosis at Cancer Research UK, said: "This is the first time we've had direct feedback from patients on such a large scale to show how the timeliness of their diagnosis colours their experience of the care they later receive. It's another  good reason to highlight the importance of diagnosing cancer as quickly as possible, not just to give patients the best chances of survival, but also to improve their experience of the care they receive throughout their cancer journey."