Response to Jeremy Hunt's plans to name and shame GPs

On 29 June 2014, The Daily Mail and The Daily Telegraph reported that Jeremy Hunt plans to name and shame GPs who inadvertently miss cancer diagnoses. This would be a grave mistake and represent a very large risk to the NHS.

Our response (below) was printed and reported on the front page of The Daily Telegraph on Monday 7 July 2014.

Sir

If there is a perception of delay in cancer diagnosis, real or otherwise, it is devastating for the patient and their family but also soul-destroying for their GP.

Sinister causes (including cancer) could explain just about any symptom in the average general practice consultation. The risk of not finding that needle in the haystack is the reason why GPs must pay thousands of pounds every year for liability insurance.

The NHS performs better than any healthcare system in the western world, at a fraction of the cost of other countries [1] because British GPs hold the dual responsibility of caring for the patient in front of them and keeping the NHS alive within its monetary constraints by avoiding unnecessary investigations and referrals as well. This is balanced by avoiding delays which might adversely affect their patients’ health.

If a doctor is negligent, including causing a delay in diagnosis, there are due processes that determine whether any wrong has been done; via the General Medical Council or courts. Naming and shaming GPs who miss cancer diagnoses is a bullying tactic which lacks evidence of effectiveness and fails to acknowledge the risks outlined above. GPs will pre-empt this by referring so many patients for tests that those who do have cancer will lose out and the NHS will be bankrupted.

This attack on British general practice is not based on fact.  The article underpinning the headlines [2] reports that only 10% of cancer patients needed more than 5 appointments before being referred for a cancer diagnosis; a published response points out that no fewer than two thirds are diagnosed at the first GP consultation.

GPs need  to be supported, not bullied; they are doing an excellent job - stop attacking them.

1. http://www.bbc.co.uk/news/10375877

2. http://www.bmj.com/content/344/bmj.e3017/rr/583036

Yours Faithfully

Resilient General Practice www.ResilientGP.org

Dr Samir Dawlatly, Jiggins Lane Medical Centre, Birmingham

Zahida Adam Sheila Adams Dr Bunmi Adeniji, Salaried GP, Shipley,. Dr Kemi Adeyemi, Salaried GP, Oldham. Dr Samrina Ahmed, GP, The Village Surgery, Blackley. Dr Tabassum Ahmed, GP, Freezywater Primary Care Centre, Enfield. Dr Freeha Ahmed, GP, The Firs, Walthamstow. Dr Nasreen Ahmed, GP, Bellingham Green Surgery, Lewisham. Dr Jessie Ahmed, GP, Cardiff. Tasmia Ahmed Nadeem Akhtar Iram Akhtar Tamara Al-Jabary Clare Aldous Stuart Alexander Dr Shimaila Ali, GP, Dr Bamford and Partners, Chorley. Mohamed Ali Rachel Ali Majid Ali Dr Kayyam Altaf, GP, Australia. UK-trained GP and ex-cancer sufferer who was referred appropriately at first consultation Laura Ambrose Dr Sobana Anandarajah, GP, Mersham Medical Centre, Croydon. Caroline Andrews Clive Anggiansah Kulsum Ansari Dr Seraj Anwer, GP, Lincoln House Surgery, Hemel Hempstead. Dr Yogasakaran Arjuna, GP, The Woodberry Practice, Winchmore Hill. Dr Ram Arora, GP, Turning Point, Wiltshire. Suzanne Arron Nitika Arya Chrissie Ashdown, Salaried GP, Ashdown Forest Health Centre Dr Mufaza Asrar, GP, Locum GP, Nottingham/Derby. Rashel Asslanian Hala Atkin, Gp principal, Skyblue medical centre, coventry Dr Karen Atkinson, GP, Lister GP Walk-in Centre, Peckham. Faisal Awan Ricky Badiani Joanne Bailey Dr Funmi Bajomo, Salaried GP, Rushey Green Group Practice, Catford, London. Dr Alexandra Baker, GP, Swanscombe Health Centre. Emma Baker Lucy Baker Dr Amy Banks, GP, Statham Grove Surgery, London. Angela Bannister Liam Barker Deb Barkway Zoe Barnard Fionnuala Barton Dr Deboshree Basu-Choudhuri, GP Principal, Nuffield House Surgery, Essex. shona batchelor Liz Bates Chris Bates Dr Amrit Baura, GP, THE SURGERY, Brighton. Jeanette Baverstock Marcus Baw Dr Dana Beale, Salaried GP, Meadowell Surgery, Watford. Dr Catherine Beanland, GP Partner, Portcullis Surgery, Shropshire. Neil Beatson Gill Beckett Dr Freda Bhatti, GP, Great Bentley Surgery, Colchester. Dr Afsana Bhuiya, GP, Dr Kateb and partners, North London. Ella Bihari Andrew Blease, Deal, The Cedars Surgery Lisa Blocq Lindsey Bluett, GP registrar Dr Kerry Boardman, Academic GP, KUMEC, King's College London, London. janani bodhinayake Ellen Boliek, United States Dr Adam Booth, Locum GP, Locum GP, Shropshire. James Booth Emily Botcher Dr Simon Braybrook, BLuetown Medical Centre, Cardiff. Siobhan Brennan Lisa Broad Angharad Brodie Dr Russell Brown, GP, Manor Park Surgery, Polegate. Ben Brown Iain Brown Dr Hannah Bryant, GP, Lyminge Surgery, Lyminge. Chloe Burges Dr Sitwat Butt, GP, ???, Harrow. Sohail Butt Dr Prit Buttar, GP, Abingdon Surgery, Abingdon. Tom Caldwell Daniel Campion, GP and OH physician, InterHealth Junaid Campwala Denise Cannadine Dr Catherine Cargill, Blackwater Medical Centre, Maldon. David Cargill Catherine Cargill Dr Daniel Carlton-Conway, GP, The Maltings Surgery, St Albans. Dr Kate Carr, Locum GP, Green Cedars Medical Centre, North London. Zara Casey Gillian Cassels Tom Cayton Rajesh Chadda Sireesha Challagalla Dr Shavi Chana, GP, The Fairfield Centre,London, London. Chris Chaplin Dr Caitlin Chasser, GP, West Street Surgery, Chipping Norton, Oxon. Earim Chaudry Emma Cheesman Shabin Chohan Dr En Min Choi, Salaried GP, Crown street surgery, West London. Moushumi Choudhury Naylea Choudry Shazeia Choudry Shazeia Choudry Mary Church Dr Natalia Ciapryna, Locum GP. Lesley Clark Stephanie Clark Anna Clayton Dr Sarah Cleverly, Salaried GP, Elizabeth Avenue Group Pracxtice, Islington. Christine Cliff Joanna Connolly Karen Cooper Maria Corretge Dr John Cosgrove, GP, Midlands Medical Partnership, Birmingham. Anna Crawford Graham Crippin Keith Cross Sarah Cubitt Josh Cullimore Alaine Cunningham Helen Cunningham Dr Laura Czech, GP, Regal Chambers Surgery, Hitchin. Dr Alessandra Dale, GP Principal, Stanley Corner Medical Centre, Wembley. Jojo Daly Dr Ranjan Dass, GP, The Alma Road Surgery, Romsey. Poulami Datta Yvonne Davey Dr Joanne Davies, GP Partner, Leach Heath Medical Centre, Birmingham. Iestyn Davies Amanda Davies Shoura Davies Debra Davis Dr Stephanie De Giorgio, The Cedars Surgery, Deal. Ellen Dean, Salaried GP, Park Lodge Medical Centre, London Dr Thirza Deboo, GP, Marlbourough Surgery, Marlborough. Sim Dehal Della Delahunty Edward Dennison Robert Depo Dr Pete Deveson, GP, Derby Medical Centre, Epsom. Avani Devkaran mhairi dewar Dr Jaz Dhillon, Freelance GP, North London. Marie Diesel-Dyer Kevin Dillon Dr Anisha Divani, GP, Oakleigh Road Clinic, London. Ross Dolan Marie Donnelly Dr Parag Doshi, Locum GP, Church End Medical Centre, North London. Kerry Douce Michelle Drage Dr Anna Draper, Salaried GP, Barnard MEdical Group, Sidcup. Sue Draper Sue Draper Dr Amrit Dugala, GP, Royal Arsenal Medical Centre, London. Steve Duke Dr Susie Earle, GP Registrar, Princess Group Practice, London. Ronnie Eaton Louise Elliott Mina Endeley, GP Ahmer Farooqi Dr Emon Farrah Malik, GP Registrar, GP Registrar, Surrey. Dr Francesca Farrell, GP, Queens Walk Surgery, Ealing. Kevin Farrington Nadim Fazlani Emma fellows Tracy Foley Mark folman Katie Foot Dr Sarah Forbes, GP, Oakwood Lane Medical Practice, Leeds. Michael Forrest Dr Caroline Forwood, Freelance GP, Freelance GP, East London. Georgina Forwood Tom Forwood, Australia Dr Jeff Foster, GP Partner, Croft Medical Centre, Leamington. Dr Elizabeth Foster, Lead GP, Hollinwood Medical Practice, Oldham. Jeff Foster Susan Foster Rosie Freedman David Freedman Alex Freeman Sophie French Lynn Frost Síona Gaffney Barbara Gaffney Dr Sophie Galloway, GP, Steyning Health Centre, Steyning. Dr Hussain Gandhi, GP, Wellspring Surgery, Nottingham. Kate Gaskell Dr Kamini Gautam, GP, KS Medical Centre, Southall. Chris Geden Diane Gerrard Hafsa Ghaffar, United States Smara Ghafoor Stephanie Giorgio, GP Principal, Cedars Surgery, Deal Amy Glossop Dr Jeremy Goad, GP, Victoria Practice, Aldershot. Jessica Gomersall Leona Gooch-Hatton, Germany Dr William Gordon-Wright, GP, Oxford Community Health Centre, New Zealand. Lisa Gorringe Dr Shikha Gosain, GP Partner, The Tudor House Med Ctre, Brent. Jonny Graham Dr Pauline . Grant, Salaried GP, St Clements Practice, Winchester. Anna Gregorowski Claire Griffiths Paula Griffiths Steve Grimshaw Wendy Grimshaw Jill Groome Carol Gubler Leah Gunatilleke Dr Srikanth Gunda, GP, Brerton Medical Practice, Rugeley. Dr Ruchika Gupta, GP, Spring Street Surgery, Epsom. Nirupam Gupta Dr Koustubh Gupte, GP, The Redhouse Surgery, Radlett. Tesan Hadzikadunic Shazia Hafeez Sarah Haines Harilal Halai Lakhsman Halai, Uganda Simon Hall Holly Halstead Elizabeth Hamblin Sian Hammond Manzur Haque Handy Harichandran Emma Harkin Stephanie Harris Robyn Harris Nigel Hart Trudi Harvey Jo Harvey Dr Zara Hasafa, GP, Studholme Medical Centre, Ashford. Sharon Heap Sherif Helmy Graham Henderson Kim Henry Dr Maria Henson, Locum GP, Locum GP, Cheltenham. Djahla Hewazy Dr James Higgin, GP, Downlands Medical Centre, Polegate. Jessica Hill Nat Hilliar Dr Emma Hilton, Salaried GP, Parkside Practice, Eastleigh. D Hipps Tom Hodson Dr Kathryn Hogg, GP, Market Lavimngton Surgery, Market Lavington. Dr Tim Hogg, GP Partner, Batheaston Medical Centre, Bath. Dr Melissa Holder, GP, Cotswold Medical Practice, Gloucestershire. Caroline Hollington Debbie Hopkins-Davies Sarah Horrocks Richard Hoskin Sharif Hossain Emma Howard Samantha Howard-Els, South Africa John Howe, GP Registrar, Presteigne Medical Centre Sue Howell Syeda Huma Kate Humphries Lisa Hunt Phil Hyde Victoria Ingham Helen Ingoe Grant Ingrams Tasneem Irshad Dr Esma Izzidien, Salaried GP, Churchill Medical Centre. Dr Lionel Jacobson, Senior Lecturer in general practice, Cardiff University. Rebecca Jacques Dr Farah Jameel, Locum GP, Locum GP, Surrey, Sussex, London. Farah Janmohamed Rebecca Jardine Lesley Jeffers Matt Jenkins Llania Jenkinson Paul Jennings Abbas Jeraj, Salaried GP, The Clapton Surgery Dr Hajane Jeyabalasingam, GP, The Orchard Practice, Kent. Dr Sukhdip Jhaj, GP, Silsden Group Practice, West Yorkshire. Fatima Jivraj Mell Johns Julie Johnson Natalie Johnston Nicola Jollie Dr Dave Jones, GP, GP Superclinic, Midland, Perth, Australia. Charlotte Jones Cemile Jones, Dr. Maden, Salaried GP Matt Jones, NHS user Evelyn Jones Vikki Jones Pamela Jordan-Byrne Poonam Jugessur Daniel Kalinowski Dr Raj Kanwar, Salaried GP, Kineton surgery, Warwickshire. Vishal Kapil Zanubia Karim Dr Krishna Kasaraneni, GP Partner, Crown Street Surgery, Rotherham. Kirsten Kassyk Mathew Kattukaran Farah Kausar Dawn Kavanagh Karen Keating Sheila Keats Annabelle Kerr Dr Latha Kestur, GP, Rowan Tree Surgery, Kent. Sara Khan, GP Principal, Abbotswood Medical Centre Meena Khan Sameer Khurjekar Farah Kidy, Salaried GP, Aylestone, Leicester Dr Bastiaan Kole, Freelance GP, Freelance GP, Fulham. Adam Konstanciak Magdalena Kostka Reena Kotecha Amisha Kothari Dr Vijay Kudari, GP, Vanbrugh Group Practice, London. Dr Jay Kuruvatti, GP, Wallace House Surgery, Hertford. Kapil Lad Reem Lammoza Brian Langshaw Rhian Last Samiah Lateef Dr Alison Lawton, Salaried GP, Park View Medical Centre, Long Eaton. Rachel Lawton Emily Layton Pamini Ledchumykanthan, Salaried GP, The Bush Doctors Audrey Lee Lauren Leishman Lynn Leishman tim leitch Dr Rob Lenart, GP, Malting Green Surgery, Colchester. Evon Leung Dr Jonathan Levy, GP, Lisbon Grove Medical Centre, London. Christian Leyland Jenny Li Craig Lintern Dr Emily Lister, GP, Spring Grove Medical Practice. Dr Kenny Livingstone, GP, Walm Lane Surgery, Willesden Green. Robert Llewelyn Dr Martyn Lobley, Senior Partner, Thamesmead Medical Associates, London. Dr Natalia Lomatschinsky, Locum GP, West Bridgford Medical Centre, Nottingham. Sophia Lomatschinsky Maria Lomatschinsky Claire Lonie David Lovell Runa Lynch Dr Mina MacDonald, Salaried GP, Spring Grove Medical Centre, Hounslow. Gillian Macgregor Alanna MacRae Tessa Madden Dr Cemile Maden, Salaried GP, Kings Langley and Bovingdon Surgeries, Kings Langley. Dr Raj Mahadevaiah, GP, Wingham and Aylesham Surgery, Kent. Dr Sahira Mahmood, Locum GP, Millway Medical Practice, London. Carla Mahmoud Dr Saman Malik, GP, Hanley Primary Care Centre, London. Emon Malik, GP Registrar, The Exchange Surgery Lizzie Mander Dr Novin Manshani, GP Principal, Lime Grove Surgery, St Helens. Dr Ruth Marchant, GP, Manorbrook Surgery, Blackheath. Peter Martin James Martin Elvis Martinez Debbie Matthews Dr Robert Mawdsley, Locum GP, Locum GP, Perth. Dr Laura Mawson, GP, Oakview Family Practice, London. Rebecca Mawson Kay Mayes Derek McAuley Beth McCarron-Nash Mary McCloskey Isabell McDowell Brian McGinty Anna McGloin Moyra Mcglynn Shaun Mcglynn Dr Kate McGuinness, GP, Stockwell Group Practice. Dr Rachel McMahon, GP, Coulby Medical Practice, Middlesbrough. Gurpinder Mehat Comaroni Melania, Romania Ruth Millican Elizabeth Mills Steph Mills, Australia Nitesh Mistry Donna Mizzi Dr Kartik Modha, GP, Friern Barnet Medical Centre, Barnet. Dr Jeenita Mohanty, GP Partner, Avenue Medical Centre, Manchester. 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