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GP s QUICK TO REFER SUSPECTED CANCER


GPs refer more than 80 per cent of suspected cancer cases within two consultations, new research has revealed. More than half (58 per cent) of patients were referred after the fi rst


consultation while a quarter were referred after two. In only fi ve per cent of cases it took fi ve or more consultations to initiate a referral. The fi ndings were published in a


report in the British Journal of Cancer which used data from the English National Audit of Cancer Diagnosis in Primary Care 2009- 2010. It covered 13,035 people with any of 18 diff erent cancers. Those diagnosed with multiple myeloma and lung cancer had high


proportions of three or more pre-referral consultations (46 per cent and 33 per cent respectively). Breast cancer and melanoma patients were generally referred sooner, with only three per cent and fi ve per cent of each patient group requiring three or more pre-referral consultations. The researchers concluded: “Developing interventions to reduce the


number of pre-referral consultations can help improve the timeliness of cancer diagnosis, and constitutes a priority for early diagnosis initiatives and research.”


QUARTER OF GRADUATES


MAKE GP FIRST CHOICE ONLY a quarter of medical graduates say general practice is their fi rst choice of specialty amid concerns over a workforce shortfall. A new study shows 28 per cent made general practice their fi rst


choice career compared with 71 per cent who chose secondary care specialties. This falls well short of the target of 50 per cent of training places allocated for GPs by 2015 which was set by the former health secretary Andrew Lansley. The fi gures, revealed in the Medical Teacher journal, were based on


more than 9,000 questionnaire responses from people who qualifi ed in 2005, 2008 and 2009, one year after they graduated.


MORE CHANCES


TO PASS MRCGP GP trainees could be given more chances to pass the MRCGP following discussions over how to address the high failure rate of international medical graduates. Under the plans, reported


recently in Pulse, trainees could be allowed six attempts at the exam rather than the current four, and greater support would also be given to international trainees. The issue was discussed at a


meeting between the RCGP, the British Association of Physicians of Indian Origin (BAPIO) and the British International Doctors Association (BIDA). The move came after offi cial


fi gures showed that, in 2010/11, the failure rate for international


graduates taking the clinical skills assessment (CSA) component of the MRCGP was 63 per cent, compared with just nine per cent for UK graduates. While the RCGP has reportedly ruled out off ering an alternative to the CSA, the College is said to be keen to continue working with BAPIO to resolve the issue. A joint statement issued after


the meeting stated that all three parties “acknowledged that there were a number of factors contributing to the lower pass rates of candidates with overseas Primary Medical Qualifi cations.” Another meeting has been scheduled to discuss the issue further.


PATIENTS TO


RATE DOCTORS PATIENTS are to be given the power to rate the service provided by their doctor under new plans announced by the prime minister. David Cameron said a new “friends and family” test would be introduced in every hospital in England from April with a view to


later extending it to GP practices and community hospitals. Under the test, patients and


staff would be asked whether they would recommend the service to a friend or relative, in a bid to expose unacceptable standards of care. Mr Cameron said it should be applied to all NHS services.


GP s NOT ENGAGING


WITH FIT NOTES DOCTORS are not using the ‘fi t note’ system as intended, according to a survey of HR professionals. An XpertHR report (tinyurl.com/a2foutd) found 62 per cent of


HR professionals felt that fi t notes had not helped them to better manage sickness absence and 65 per cent said that fi t notes had not helped reduce overall absence. A prime aim of the fi t note system - introduced in 2010 - was for


doctors to off er employers greater clarity on the nature of any condition preventing an employee returning to work. GPs are asked to tick a “may be fi t for work” option and provide more detailed medical information about how the employee can be eased back into work. In the survey, Personnel Today reports that 78 per cent of


respondents said the “may be fi t for work” option had either never been ticked in any fi t notes received or had been ticked in fewer than a quarter of cases over the past two years. And 38 per cent of organisations reported that GPs never provided any comments on fi t notes. When doctors did off er advice, 73 per cent of employers went against that advice and made alternative arrangements to facilitate a return to work. Report author Charlotte Wolff said: “Our research [shows] that


doctors appear to be too busy to use the fi t note in an intelligent way and frequently have a limited understanding of the nature of the employee’s work.” However, 68 per cent of respondents did feel that the


introduction of fi t notes had helped to stimulate a more open dialogue on employees’ return to work after illness.


Read more on p7


FIT NOTES?


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