Quality standard

Quality statement 1: GP direct access to MRI

Quality statement 1: GP direct access to MRI

Quality statement

GPs have direct access to MRI for adults with suspected brain tumour.

Rationale

Enabling GPs to use direct access for MRI will speed up the diagnosis process for adults with suspected brain tumour and may reduce the number of outpatient appointments needed. If MRI is contraindicated, GPs should use a CT scan.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured and can be adapted and used flexibly.

Structure

Evidence of local arrangements to give GPs direct access to MRI for adults with suspected brain tumour.

Data source: Data can be collected from information recorded locally by provider organisations, for example, service protocols that may be developed to support NHS England's Neurosurgery Transformation Programme.

Process

Proportion of referrals for brain MRI that are GP direct referrals.

Numerator – the number in the denominator that are GP direct referrals.

Denominator – the number of referrals for brain MRI.

Data source: NHS England's Diagnostic imaging dataset includes details of GP direct referrals for brain MRI.

Outcome

Time from presentation at GP to brain tumour diagnosis.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.

What the quality statement means for different audiences

Service providers (primary care, secondary care and community imaging services) ensure that direct access referral pathways are in place for GPs to refer adults with suspected brain tumour for MRI. These may be developed to support NHS England's Neurosurgery Transformation Programme. Providers ensure imaging results are clear to inform GP decision making.

Healthcare professionals (GPs) can refer adults with suspected brain tumour directly for MRI.

Commissioners (such as integrated care systems, clinical commissioning groups and NHS England) ensure GP services can use direct access pathways to refer adults with suspected brain tumour directly for MRI. These may be developed to support NHS England's Neurosurgery Transformation Programme.

Adults with symptoms that may suggest brain tumour can be referred directly by their GP for an MRI scan to find out if their symptoms are caused by brain tumour. This will ensure that brain tumours can be diagnosed as quickly as possible.

Source guidance

Suspected cancer: recognition and referral. NICE guideline NG12 (2015, updated 2021), recommendation 1.9.1

Definitions of terms used in this quality statement

Direct access

When a person is referred directly by their GP for a test in a specialist service and the GP retains responsibility for the person's care, including following up and acting on the results. [Adapted from NICE's guideline on suspected cancer, terms used in this guideline]

Adults with suspected brain tumour

Adults with progressive, sub-acute loss of central neurological function. [NICE's guideline on suspected cancer, recommendation 1.9.1]