NICE’s contentious skin cancer guidance seems to be triggering a steep increase in hospital activity throughout the UK, according to an article published by Pulse. During the last nine months of 2008 GP dermatology referrals rose by 24% compared the same period in 2007 (figures gathered from 30 NHS acute trusts).

This means 140,000 extra GP dermatology referrals if the numbers are replicated nationwide.

Data gathered by Pulse using the Freedom of Information Act provide initial evidence of which clinical areas have fuelled the successive quarterly jumps in overall referrals, which have pushed many Primary Care Trusts (PCTs) towards financial crisis.

The largest contributor to this increase in referrals was dermatology – with an average of 814 extra referrals per trust over the period. However, GP referrals in orthopaedics, ophthalmology and Ob/Gyn also saw significant rises.

The increase in dermatology referrals comes after a major row over the restrictions placed on GPs by NICE skin cancer guidelines branded ‘unworkable’ by the GPC. The Royal College of General Practitioners (RCGP) warned at the beginning of January this year that the NHS would come to a standstill if GPs stopped performing surgery because they were worried about acting outside NICE guidance.

If a GP does not want to end up in court he/she should follow NICE guidance to the letter, urged the Medical and Dental Defence Union of Scotland, provoking fears that referrals could rise even further as the number of GP skin operations falls.

RCGP chair Professor Steve Field said the changes in referral patterns were probably partly due to the NICE skin cancer guidance “It has probably made people think about what they are doing and refer more. The NICE guidance should be looked at and changed,” he said.

A GP who is in doubt over the diagnosis of skin cancer should refer the patient to a specialist, said a NICE spokesperson. The spokesperson added that GPs still have a ‘significant role’ in improving outcomes for people with skin tumours.

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Source
John Robinson
http://www.pulsetoday.co.uk

Written by – Christian Nordqvist