Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment his Department has made of the effect of the lack of direct guidance to GPs on suspected cases of metastatic cancers in the NICE guideline Suspected cancer: recognition and referral on the (a) time taken for the diagnosis, (b) accuracy of diagnosis and (c) number of cases of such cancers.

No assessment has been made by the Department on the potential effect of not including specific recommendations on metastatic symptoms in the National Institute for Health and Care Excellence (NICE) guideline for suspected cancer published in June 2015. However, we recognise that metastatic cancers can present with vague or unusual symptoms that might be harder to diagnose quickly.

The scopes of NICE guidelines are developed through consultation with stakeholders, including patient groups. NICE has advised that during the scope consultation for the clinical guideline on suspected cancer, it was noted that recommendations on recurrence or metastases would be better placed in site specific cancer guidance. ‘Suspected cancer: recognition and referral’ is designed to help general practitioners (GPs) refer people with suspicious symptoms promptly and to the right pathway. Some of these symptoms will be those of advanced disease, but it is not always possible to specify or exclude metastatic disease at this level of granularity.

NICE developed a guideline in 2010 on metastatic malignant disease of unknown primary origin in adults: diagnosis and management.

More generally, Wave 2 of the Accelerate, Coordinate, Evaluate programme led by NHS England is under way, testing a new, multi-disciplinary diagnostic centre approach to diagnosing patients. The model is focussed on patients with vague or unclear but concerning symptoms, to ensure they receive a diagnosis as quickly as possible. If successful, multi-disciplinary diagnostic centres will enable patients to receive a suite of tests following referral from their GP, avoiding a situation where patients go between primary and secondary care and multiple specialisms several times before receiving a diagnosis.

A new Diagnostic Capacity Fund has been rolled out to support initiatives to build the capacity and capability of diagnostic services across the country. The fund will focus on redesigning and streamlining patient pathways, to ensure that patients receive the right tests at the right time, as efficiently as possible.