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<p><em>Improving Outcomes: A Strategy for Cancer</em>, published on 12 January 2011,
stated that general practitioners (GPs) need easy access to the right diagnostic tests
to diagnose or exclude cancer earlier. The strategy committed over £450 million over
four years, to achieve early diagnosis of cancer, including improving access to key
diagnostic tests, such as Magnetic Resonance Imaging (MRI) scans to support the diagnosis
of brain cancer. The funding was also designed to cover subsequent testing and treatment
in secondary care.</p><p> </p><p>In 2012, the Department published <em>Direct Access
to Diagnostic Tests for Cancer</em>,<em>Best Practice Referral Pathways for General
Practitioners. </em>The document includes criteria for accessing key diagnostic tests
including MRI brain scan and aims to raise awareness of the symptoms that require
urgent referral to specialists and sets out where a direct referral for an MRI brain
scan may benefit patients through achieving a faster diagnosis. GPs are able to access
these tests directly in cases where the two week urgent referral pathway is not appropriate
but a patient's symptoms require further investigation. The intention is that more
people presenting with relevant symptoms will be tested and at an earlier stage.</p><p>
</p><p>NHS England monitors the use of these diagnostic tests through the Diagnostic
Imaging Dataset. Latest provisional data published by NHS England on 27 March 2014
for the period November 2012 to November 2013, showed that over a quarter of all tests
that may have been used to diagnose or discount cancer were requested by GPs under
direct access arrangements. In that period, 509,215 MRI tests were requested including
35,055 through direct GP access arrangements. The published data is available at:</p><p>
</p><p><a href="http://www.england.nhs.uk/statistics/statistical-work-areas/diagnostic-imaging-dataset/diagnostic-imaging-datasetdiagnostic-imaging-dataset-2013-14-data/"
target="_blank">www.england.nhs.uk/statistics/statistical-work-areas/diagnostic-imaging-dataset/diagnostic-imaging-datasetdiagnostic-imaging-dataset-2013-14-data/</a>.</p><p>
</p><p>Information on diagnosis rates of brain tumours is not centrally collected.
Information on number of patients with suspected brain or central nervous system tumours
who were seen by a specialist within two weeks from a GP referral is provided in the
attached tables, for the last 10 years.</p><p> </p><p>Before 2009, the operational
standard for two week waits was 98%. Starting from the 1 of January 2009, the basis
for reporting waiting times data was changed. The new standards were set to be more
in line with the already implemented referral to treatment routes. The scope of cover
for the new standards was widened (as set out in the Cancer Reform Strategy 2008),
and the collection was made simpler by not using clock pauses. From 2009 onwards the
operational standard for two week waits was set to 93% (assumed to be the maximum
sustainable performance level) including tolerances for:</p><p>- The number of patients
who make themselves unavailable or decline an appointment within two weeks.</p><p>-
Patients who cancel a booked outpatient appointment (giving advance notice), and rebook
appointments outside of 14-days.</p>
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