School of Health Sciences, University of Surrey, Guildford.
Department of Applied Health Research, University College London, London.
Br J Gen Pract. 2019 Jun;69(683):e413-e421. doi: 10.3399/bjgp19X702677. Epub 2019 Mar 11.
The Faster Diagnosis Standard (FDS) is to be introduced in England in 2020. This standard is a new policy in which patients should have cancer ruled out or diagnosed within 28 days of referral.
To explore public attitudes towards the FDS within the context of their recent referral experiences.
Four 90-minute focus groups (two in Guildford, two in Bradford).
Participants aged >50 years without a current cancer diagnosis ( = 29), who had completed certain diagnostic tests, for example, ultrasound, and received results within the last 6 months were recruited. Age, education, and sex were evenly distributed across groups through purposive sampling.
The largest cause of concern was the waiting process for obtaining test results. Most had experienced swift referral, and it was difficult for participants to understand how the new standard could impact upon time progressing through the system. Responsibility for meeting the standard was also a concern: participants did not see their own behaviours as a form of involvement. The GP's role was conceptualised by patients as communicating about their referral, establishing patients' preferences for information, and continued involvement at each stage of the referral process. The standard legitimised chasing for test results, but 28 days was considered too long.
Patients should be asked what they would like to know about their referral. GPs should be more transparent about the referral process and the potential for a lack of clarity around next steps.
2020 年,英国将引入更快诊断标准(FDS)。该标准是一项新政策,要求患者在转诊后 28 天内排除或确诊癌症。
在最近转诊经历的背景下,探讨公众对 FDS 的态度。
4 个 90 分钟的焦点小组(2 个在吉尔福德,2 个在布拉德福德)。
招募年龄>50 岁、无当前癌症诊断(=29 岁)、已完成某些诊断测试(如超声检查)且在过去 6 个月内获得结果的患者。通过有目的的抽样,在年龄、教育程度和性别方面在小组之间均匀分布。
最令人担忧的是获得测试结果的等待过程。大多数人都经历了迅速转诊,参与者很难理解新标准如何影响系统的进展时间。达到标准的责任也是一个问题:参与者不认为自己的行为是一种参与形式。患者将 GP 的角色概念化为传达转诊信息、确定患者对信息的偏好以及在转诊过程的每个阶段继续参与。该标准使追查测试结果合法化,但 28 天被认为太长。
应询问患者他们希望了解有关转诊的哪些信息。GP 应更透明地了解转诊过程以及下一步可能存在的不明确情况。