Intended for healthcare professionals


Is the two week rule for cancer referrals working?

BMJ 2001; 322 doi: (Published 30 June 2001) Cite this as: BMJ 2001;322:1555

Not too well

  1. Roger Jones, Wolfson professor of general practice (,
  2. Greg Rubin, professor of primary care,
  3. Pali Hungin, professor of general practice
  1. Guy's, King's, and St Thomas's School of Medicine, 5 Lambeth Walk, London SE11 6SP
  2. University of Sunderland, Sunderland SR2 7BW
  3. University of Durham, Durham DH1 3HN

    Mortality rates in the United Kingdom for several cancers compare unfavourably with those in other countries,1 and this may be explained at least partly by British patients having more advanced disease at the time of treatment than their European counterparts. Morbidity and mortality can be reduced through primary and secondary prevention, including screening; by early detection; and by prompt and effective treatment. Last year, in the context of the NHS's disgracefully long waiting lists, the government pledged that patients with suspected cancer would be seen by a specialist within two weeks of referral by their general practitioner. The aim was to reduce delays between presentation, diagnosis, and treatment. The two week rule has now been implemented across a range of specialties, supported by widely distributed information about risk factors and criteria for rapid referral for suspected cancer. How is it working?

    Local rapid access referral mechanisms have been established, including specially designed forms and direct electronic access to outpatient appointments for patients meeting prespecified criteria. In addition, the government established the cancer services collaborative programme, creating nine cancer networks covering about 15 million people, aimed at optimising systems of care and improving …

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