GP Direct Access to CT for Suspected Pancreatic Cancer
We are writing to update you on GP access to urgent direct investigations for suspected cancer at Barts Health. As you may know, NICE guidelines (NG12; Suspected cancer: recognition and referral) recommended that GPs consider referring patients directly for urgent (within two weeks) investigations in specific clinical situations. The imaging departments across Barts Health will make this service available from 01 September 2021 providing equitable access to NG12 diagnostics across London.
Radiology Process and Safety Netting
You will be able to request an urgent CT abdomen & pelvis for suspected pancreatic cancer via T-quest. For those practices using C the Signs (in Newham and Waltham Forest) this will be included within the risk assessment and recommendations.
GPs should only request an investigation urgently if the patient meets the NICE criteria. Radiology services are under considerable strain, and a request to undertake a test within two weeks should be clearly justifiable on clinical grounds.
- Consider an urgent direct access CT scan (to be performed within 2 weeks) to assess for pancreatic cancer in people aged 60 and over with weight loss and any of the following:
- diarrhoea
- back pain
- abdominal pain
- nausea
- vomiting
- constipation
- new‑onset diabetes. [2015]
- The order is built into T-quest with a description of ” CT Pancreas NICE NG12″ and will only be visible for patients 60 and over.
- Patients must have a recent serum creatinine within the last 3 months, please include the result and date of the test in the clinical details box.
- If you have any queries about requesting this diagnostic test, please email the Radiology team for further information and advice.
Tower Hamlets: bartshealth.imagingadviceandsupportrlh@nhs.net
Newham: Radiology.gpsupport@nhs.net
Waltham Forest: Bartshealth.imaging-appointments@nhs.net
- Practices should ensure they have safety netting systems to follow up patients referred in this way to check that the test has been undertaken within two weeks, and the report received.
Onward Referral
Where the result indicates a suspicious lesion, GPs should refer to the relevant 2WW pathway.
The CT report will signpost the referrer to the most appropriate next step where for example a benign lesion is identified on the scan.
Education & Resources
There is an online learning resources available on Gateway C and the Healthy London Partnership supporting early diagnosis of Pancreatic Cancer, these can be accessed via the web links below.
Course: Pancreatic Cancer – Early Diagnosis