Yesterday it was announced that NICE has updated and redesigned its guidelines to support GPs to recognise the signs and symptoms of 37 different cancers and refer people for the right tests faster.
The update, which is the first for 10 years, includes new guidelines for brain and CNS tumours.
The new guidelines are:
Consider an urgent direct access MRI scan of the brain (or CT scan if MRI is contraindicated) (to be performed within 2 weeks) to assess for brain or central nervous system cancer in adults with progressive, subâ€‘acute loss of central neurological function. [new 2015]
Children and young people
Consider a very urgent referral (for an appointment within 48 hours) for suspected brain or central nervous system cancer in children and young people with newly abnormal cerebellar or other central neurological function. [new 2015]
These guidelines overlay the red flags that currently exist for GPs for MRI scans, which recommend the specific symptoms and criteria required for referral.
In this sense, the new guidance is good as it enhances what already exists.
BUT this is all water in the sand. Lowering the threshold for patient referral for scans will only increase the demand. The NHS is already struggling to cope with the current levels of demand. And, it’s worth note that only 1% of people are diagnosed with a brain tumour following an urgent referral from the GP (this is not 1% of the population, but 1% of people who go to the GP with what they think are symptoms of a brain tumour).
So whilst this is good news, unless there is increased investment in diagnostic services, patients will be waiting longer for results, diagnoses will be delayed, stress levels will rise and outcomes will therefore not improve. If anything, they will be worse.