Implementing the 2-week wait rule for cancer referral in the UK: general practitioners' views and practices.
Implementing the 2-week wait rule for cancer referral in the UK: general practitioners' views and practices.
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DOI：
10.1111/j.1365-2354.2004.00447.x
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发表时间：
2004-03-01
影响因子：
2.1
通讯作者：
Raju, KS
中科院分区：
文献类型：
--
作者：
Dodds, W;Morgan, M;Raju, KS
癌症转诊的两周等待规则于2000年12月生效，适用于英国国家卫生服务系统治疗的所有癌症。这一目标的实现最初取决于全科医生的适当和及时转诊。全科医生的意见和转介的做法下，2周的等待规则进行了审查的基础上，邮政调查的508个全科医生在内部伦敦地区（65%的响应）。转诊方式的数据表明，90%的全科医生使用紧急疑似癌症表格，尽管38%的人也发送了进一步信息的信件。全科医生普遍认为2周等待规则在改善患者的初始访问方面效果良好，50%的人认为与医院的沟通有所改善。然而，46%的人表示了一些担忧，包括当地癌症网络所需的不同表格所带来的问题，缺乏乳腺癌专用转诊表格，以及失去自主权的感觉。全科医生也承认，由于临床不确定性和患者压力的影响，以及他们对非目标转诊等待时间增加的担忧，这一规则下存在过度转诊的因素。因此，调查表明，全科医生对2周等待规则普遍持积极态度，但发现了一些实施问题，包括需要标准化的国家癌症转诊表。
The 2-week wait rule for cancer referrals became effective in December 2000 for all cancers treated by the National Health Service in the UK. Attainment of this target depends initially on appropriate and timely referral by general practitioners (GPs). General practitioners' views and referral practices under the 2-week wait rule were examined based on a postal survey of 508 GPs in an inner London area (65% response). Data on mode of referral indicated that 90% of GPs used the urgent suspected cancer form, although 38% also sent a letter with further information. General practitioners generally regarded the 2-week wait rule as working well in terms of improving patients' initial access, and 50% thought communication with the hospital had improved. However, 46% expressed some concerns, including problems arising from the different sets of forms required by local cancer networks, the lack of a dedicated referral form for breast cancer, and feelings of a loss of autonomy. General practitioners also acknowledged an element of over-referral under this rule due to the effects of clinical uncertainty and patient pressure and their concerns about increased waiting times for non-target referrals. The survey therefore indicates that GPs are generally positive about the 2-week wait rule but identified some problems of implementation including a need for standardized national cancer referral forms.