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Pharmacists to assess cancer symptoms and refer patients to specialists | Cancer



People with potential signs of cancer will be able to get assessed and referred for a hospital checkup in high street pharmacies under new NHS plans to speed up diagnosis of the disease.

The scheme will mean that those in England with lumps, a cough, bleeding or other cancer symptoms will no longer need to see a GP before being referred to a specialist. It will take some of the workload off hard-pressed family doctors and give patients another option.

Amanda Pritchard, NHS England’s chief executive, announced the initiative in a speech on Tuesday to thousands of senior health service staff at the organisation’s annual conference.


Pritchard billed it as a major innovation to help it achieve its aim of increasing the number of cancers in England found at an early, more treatable stage from half to three-quarters by 2028. Britain has long had a poor record of spotting cancer early compared with other European countries.

Hundreds of pharmacists have already indicated their interest in becoming the first people to be trained to take on this new role. They will be able to refer people whose symptoms they believe may be signs of cancer to have diagnostic tests, such as a scan or endoscopy.

The scheme will operate initially as a pilot in an undisclosed number of areas of England.

However, GP leaders warned that pharmacists could miss cases of cancer unless they were trained in detection of the disease to the same high level as family doctors.


Pritchard also disclosed that people who may have liver cancer, which is closely associated with heavy alcohol consumption, will from this month be able to get scanned in the back of trucks. These will be parked near GP surgeries, in town centres, at supermarkets and close to homeless hostels and food banks, to encourage groups who often do not seek advice about cancer symptoms for months after they have appeared, such as men and those in poorer areas.

A similar initiative has led to scores of cases of lung cancer being spotted earlier than if the people involved had eventually gone to discuss their concerns with their GP. NHS England is also launching a new programme of genetic testing for mutations of the breast cancer gene among people of Jewish heritage, who are 10 times more likely to have them than the general population.

“From liver trucks travelling around the country to genetic testing and high street checks, we want to make it as easy as possible for those most at risk to get vital, life-saving tests,” the NHS boss said in Liverpool.

Cancer charities said the plans could help lead to speedier diagnosis. “By changing the way people engage with the health service we have the potential to help diagnose more cancers at an earlier, more treatable stage,” said Michelle Mitchell, Cancer Research UK’s chief executive.


Nick James, a professor of prostate and bladder cancer research at the Institute of Cancer Research, said pharmacist assessments could improve the NHS’s poor record on early diagnosis: “One in three cancers in the UK are diagnosed in A&E. For many of these patients, their cancer will have spread and they will be less likely to survive.

“The UK falls behind many other European countries for cancer survival. Innovative healthcare initiatives that help to drive early diagnosis of cancer should be strongly supported.”

Dr Richard Van Mellaerts, executive team member of the British Medical Association’s GP committee, welcomed the initiative. “Having more staff across the community who are trained to spot the signs of cancer just makes sense,” he said, but added: “It’s essential that any cancer detection training matches the standards that GPs work to, to ensure that no potential cases are missed.”

Prof Martin Marshall, the chair of the Royal College of GPs, said: “GPs already work closely with colleagues working in community pharmacy and we have great respect for their skills.


“What’s vital is that those pharmacists taking part in the scheme have the appropriate training and support – both to identify potential signs of cancer and to support patients who may be concerned or anxious – and that there is enough capacity in onward services to cope with increased demand against existing backlogs.”

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