Remote GP consultations feature in more than half of reviewed delayed cancer diagnosis claims

Remote GP consultations featured in more than half of a group of clinical negligence claims involving delayed cancer diagnoses, according to an NHS Resolution review highlighting opportunities to improve early cancer detection.

The review examined 105 completed claims relating to delayed cancer diagnosis in general practice over a seven-year period to March 2023.

Remote consultations featured in 53% of the claims reviewed, with NHS Resolution highlighting the importance of comprehensive history-taking when a physical examination is not possible.

The findings do not mean remote consultations themselves caused the delays. NHS Resolution stressed that the cases represent a comparatively small number of instances where failures were identified, against a backdrop of large numbers of safe consultations and record levels of urgent suspected cancer referrals.

However, the review identified areas where improvements could reduce the risk of cancer being diagnosed late, including stronger diagnostic processes, better communication between patients and healthcare professionals and improvements in how information is shared across the healthcare system.

Of the patients included in the review, 65.7% were ultimately diagnosed with stage three or stage four cancer. Some 40% of diagnoses followed either a routine referral or attendance at an emergency department rather than an urgent suspected cancer referral.

The five cancer groups accounting for the largest number of settled claims were colorectal cancer at 20%, skin cancer at 18%, breast cancer and prostate cancer at 13% each, and other urological cancers at 9.5%.

The review also identified a potential disparity among younger patients. Almost three-quarters – 73.5% – of claimants aged under 50 were women, prompting concerns about potential differences in the detection of early-onset cancers.

NHS Resolution has recommended improvements including better integration of digital systems so repeated healthcare attendances can be identified, enhanced training for clinicians conducting remote consultations and greater use of pathways designed for patients experiencing non-specific symptoms.

The organisation said each delayed diagnosis represented an opportunity to learn and improve patient safety.

Early diagnosis remains critical to cancer outcomes, with NHS England stressing that identifying cancer at an earlier stage can significantly increase the chances of successful treatment.

The findings underline the need for remote and telephone consultations to be supported by effective safety-netting, appropriate escalation and access to face-to-face assessment where symptoms cannot be adequately evaluated remotely.

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