Intended for healthcare professionals


Direct access to imaging for cancer from primary care

BMJ 2023; 380 doi: (Published 09 February 2023) Cite this as: BMJ 2023;380:e074766

Linked Analysis

Early diagnosis of cancer: systems approach to support clinicians in primary care

  1. Samuel W D Merriel, NIHR academic clinical lecturer1,
  2. Igor Francetic, research fellow1,
  3. Peter Buttle, patient representative
  1. 1Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
  1. Correspondence to: S W D Merriel Samuel.merriel{at}

A worthwhile policy undermined by shortfalls in workforce and scanner capacity

In November 2022 the NHS chief executive, Amanda Pritchard, announced that all general practitioners in England will have direct access to diagnostic imaging for patients with concerning symptoms that fall outside the criteria for urgent referral of patients with suspected cancer.1 The plans build on the rollout of 160 community diagnostic centres, scheduled for completion by 2025,2 which provide more local imaging services outside acute hospitals. Exactly what constitutes “concerning symptoms” has not yet been defined,3 and investigating and diagnosing cancer in patients with non-specific symptoms is challenging, as discussed by Black and colleagues in a linked article (doi:10.1136/bmj-2022-071225).4

The policy announced by NHS England could help reduce longstanding inequalities in GP access to diagnostic imaging that currently exist between NHS regions.5 For example, the proportion of general practices with access to magnetic resonance imaging (MRI) varies from 20% to 85% among regions. Direct …

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