Direct access to mammography for GPs being examined

The National Cancer Control Programme (NCCP) is considering introducing referral pathways for breast cancer whereby GPs would have direct access to mammography, the Medical Independent (MI) can report.

The NCCP guideline development group is currently reviewing and developing new breast GP referral guidelines.

A spokesperson for the Programme told MI: “As part of this process, the NCCP is redesigning the GP referral pathway for the symptomatic breast clinics and we envisage that GP access to mammography will be available for select patients, as outlined in the new guidelines.”

“Implementation of the service redesign will be on a phased basis, dependent on cancer centre resources.”

 When this review is completed, it will provide the evidence for the use of GP access to mammography in the recommended settings on a national basis. In addition, “what works well” in some cancer centres will be explored as part of the review, according to the spokesperson.

“Essentially, any access for GPs in the future will reflect a re-direction of referrals from surgical clinic to radiology, rather than opening up new indications.”

Speaking recently to MI, Director of the NCCP Dr Jerome Coffey said Beaumont Hospital, Dublin, and St Vincent’s University Hospital, Dublin, regularly meet their targets for seeing breast cancer patients. He attributed this to the referral pathway employed by the hospitals, in which GPs are given access to mammography when required.

“My understanding is that Beaumont and Vincent’s over many years have given GP access to mammography, and any mammogram that isn’t pristine gets flagged and goes to clinic,” he explained.

“So a lot of patients will get assessed by their GP, get a mammogram and will not need to go near the clinic. And the question is, if that works so well, should not the other cancer centres be considering it? So we have a group working on it. We have a literature review done and my understanding is that a decision will be made before the end of the year, should other centres move toward that pathway.”