Over 250 000 people in England are diagnosed with cancer each year, and 130 000 suffer cancer-related deaths annually (Department of Health 2012).With ever-increasing financial pressure on the KlHS, correctly diagnosing, referring and allocating resources is essential.GPs see, on average, between eight and nine new cancer patients per year.However, many more patients have a clinical picture indicative of cancer, thus complicating the decision to refer to secondary services (National Cancer Intelligence Network, 2010).The NHS Cancer Plan in 2000 demonstrated dedication to improving cancer outcomes by implementing a maximum 2-week wait (2ww) for all cancer referrals (NHS, 2000).On average a CP will make around 25 2ww referrals annually (Department of Health, 2011). Firdale Medical has a practice population of 7868 patients and a 2ww cancer detection rate of 7.03, which is the lowest in the Vale Royal Clinical Commissioning Group (CCG) (NHS Vale Royal CCG, 2011).A four-fold variation in 2ww referral numbers across Primary Care Trusts was recently reported, highlighting the need for a closer look at the nature of referring practice and what factors affect the decision to refer (National Audit Office, 2010).
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