Cancer patients risk misdiagnosis under Labour's plans to cut 'unnecessary' appointments, GPs warn

By SHAUN WOOLLER, EXECUTIVE HEALTH EDITOR Published: 16:37, 21 April 2026 | Updated: 16:40, 21 April 2026 Cancer patients face diagnosis and treatment delays under Labour’s plans to cut ‘unnecessary’ appointments, doctors warn. New Government and NHS rules require GPs to seek specialist advice before referring patients to hospital, where it is clinically appropriate to do so. This ‘advice and guidance’ (A&G) process is seen by NHS England as a ‘key part’ of avoiding ‘unnecessary' outpatient appointments, according to information on its website. Ministers say it will allow patients to start more appropriate treatment sooner, stopping thousands waiting weeks for a pointless hospital appointment. But GPs have raised concerns about specialists downgrading their cancer referrals to A&G, creating a risk of missed diagnoses. The Conservatives say the process is simply a form of rationing and accuse the Government of ‘massaging’ the numbers to keep hospital waiting lists artificially low. The Royal College of Physicians (RCP) today warned A&G demand could mean patients needing specialist care face delays owing to the rise in workloads for senior doctors. A&G involves a GP seeking help from a specialist by telephone, email or other digital method. New Government and NHS rules require GPs to seek specialist advice before referring patients to hospital, where it is clinically appropriate to do so. The RCP pointed to NHS England figures released last week showing the total number of requests for A&G in February stood at 305,000, an increase of 26 per cent from the same period last year. Across all types of specialist advice, total requests reached 1.1 million, nearly a two-fold increase since records began in April 2022, the RCP said. It added that demand is expected to grow further due to A&G becoming embedded in the GP contract. The RCP said people could expect delays to being seen because specialists are expected to maintain direct clinical services while absorbing growing volumes of A&G activity. Professor Mumtaz Patel, president of the RCP, said: ‘Our concern is that if patients face delays in accessing specialist input, conditions may worsen before the right care is provided. ‘When that happens, people can end up seeking help in emergency care because they feel they have nowhere else to turn. ‘These reforms must not create new barriers to timely specialist care or inadvertently push more patients into an already overstretched urgent and emergency care system.’ Dr Katie Bramall, chairman of the British Medical Association's GP committee, has previously said the risks of A&G are ‘a huge concern for every single GP I meet and speak to’. Professor Mumtaz Patel, president of the RCP, warned there is a risk patients may get worse before they receive the advice they need. ‘It should be a huge concern for every patient too,’ she added. She said the policy was ‘awful for patients’ and politically driven. Wessex Local Medical Committee, which represents GPs in the area, said: ‘When a GP assesses that a patient needs specialist care, that assessment can now be overridden remotely - by a clinician who has not seen the patient. ‘We have seen a case in our region in which an urgent cancer referral was converted to an A&G response more than once rather than accepted as a referral, and where we believe the diagnosis that followed was delayed.’ A Department of Health and Social Care spokesperson said: ‘The advice and guidance initiative is giving patients faster access to specialist expertise without needing to wait for a hospital appointment, helping to get people the right care faster and reduce unnecessary referrals which waste vital clinical time. ‘The forthcoming 10 Year Workforce Plan will set out plans to support doctors and improve their working lives further, making sure we have the right people in the right places to create an NHS fit for the future.’ The comments below have not been moderated. The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. By posting your comment you agree to our house rules. Do you want to automatically post your MailOnline comments to your Facebook Timeline? Your comment will be posted to MailOnline as usual. Do you want to automatically post your MailOnline comments to your Facebook Timeline? Your comment will be posted to MailOnline as usual We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook. You can choose on each post whether you would like it to be posted to Facebook. Your details from Facebook will be used to provide you with tailored content, marketing and ads in line with our Privacy Policy.