Abstract

Background

The Faster Diagnosis Standard (introduced in England from 2020) is a new patient-centred policy stipulating that patients must have cancer ruled out or diagnosed within 28 days of referral for diagnostic testing. We explored public attitudes towards this new standard, within the context of their own recent referral experiences.  

Method

Four 90-minute focus groups were conducted (2 Guildford, 2 Bradford, n=29), recruiting men and women aged 50+ years without a current cancer diagnosis, who had completed certain diagnostic tests (e.g. ultrasound) and received results within the last 6 months. Age, education and gender were evenly distributed across groups through purposive sampling. Topic guide was developed with input from people with cancer, Cancer Research UK, and the public.

Results

The biggest cause of concern to patients was the process of waiting for and obtaining test results. Most had experienced swift referral/testing, and it was difficult for participants to understand how the new standard could impact upon time spent progressing through the system. Responsibility for meeting the standard was also a concern: patients did not see their own behaviours such as accepting a cancellation appointment as a form of involvement in the standard being met. The GP’s role was conceptualised as communicating with the patient about their referral, establishing their preferences for information and continued involvement at each stage of the referral process. The standard legitimised chasing for test results, but 28 days was considered too long.

Conclusion

Patients should be asked what they would like to know about their referral. Where appropriate, GPs should be more transparent about the referral process and the potential for lack of clarity around next steps, timescales and outcomes. Patients should know that it’s ok to make use of opportunities perceived as ‘manipulating the system’ but this needs to be balanced against adding to existing patient burden.