NHS not ready to deal with extra cancer referrals by pharmacists, charity fears

The Pancreatic Cancer Action (PCA) charity has raised concerns about the NHS's “diagnostic capacity to deal with the number of referrals” from pharmacy teams following the introduction of the new community pharmacy cancer diagnosis pilot. 

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PCA: There is “an estimated shortage of 1,934 radiologists across the UK”

Under the pilot – which NHS England and NHS Improvement announced yesterday – patients who present with symptoms including a persistent cough, difficulty swallowing or blood in their urine can be directly referred to specialists by community pharmacy teams for scans and checks, without having to see a GP.

PCA, which helped shape the pilot, campaigned for pharmacists to assess and refer patients in this way “for over a decade” and “developed proposals of what a system of cancer referrals would look like for pharmacists” with the NHS Cancer Programme, it wrote in a statement yesterday (June 15).

Pharmacists offering the service have the potential to save “thousands of lives” by making referrals, the charity said.

However, “there is still some concern that [there] will not be the diagnostic capacity to deal with the number of referrals made by our highly qualified pharmacist community”, it noted.

PCA founder and CEO Ali Stunt said the charity’s concerns follow “major problems with diagnostic capacity and workforce vacancies creating backlogs of referrals currently”.

For the pilot to be successfully implemented, “the system [pharmacists] are referring into needs to be fit for purpose” on top of teams receiving “the necessary training”, she stated.

Jill Loader, deputy director for pharmacy commissioning at NHS England and NHS Improvement, announced yesterday that training by the British Oncology Pharmacy Association – developed by C+D award winner pharmacist Jackie Lewis and her team – is now available via the e-learning for health platform.

Shortage of radiologists and radiographers

A PCA spokesperson told C+D today that there is “an estimated shortage of 1,934 radiologists across the UK, equivalent to a 33% shortfall for what is needed to manage the number of referrals”. “A similar staff shortage exists among radiographers,” they said.

“Without the workforce to operate and assess the results of scans, urgent cancer referrals will continue to be downgraded to hit targets and those not downgraded will see increasing delays,” the spokesperson commented.

Ade Williams, lead pharmacist at Bedminster Pharmacy in Bristol and PCA pharmacist ambassador, acknowledged the issues with diagnostic capacity.

However, this does not “diminish the value of these referrals”, he stressed.

The workforce shortages need to be acknowledged, he conceded. “If the data tells us today that there’s a shortage, it means that if that shortage isn’t addressed… it will only get worse if there are more referrals,” he said.

“It is important that underpinning all these new services is the rigour of research and data. What we want to be able to say is that community pharmacy being able to do part of the pathway did not cause problems,” Mr Williams added.

But he stressed that the pilot offers pharmacy teams an opportunity to “proactively save more lives”.

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