Pressure to provide more GP appointments is making it harder to include checks for gynaecological cancers within the 10-minute slots, doctors have said. Dr Amara Naseem says her clinics always overrun as it takes about 20 minutes to sensitively take a detailed history and carry out internal examinations. A reduced number of practices in her area means she has taken on more patients and fears there is a risk that women will not raise gynaecological symptoms or attend screenings if appointments are rushed, painful or not handled well.
The Welsh government said it was increasing investment in primary care and recruiting up to 100 extra GPs. Research by cancer charity Tenovus, in support of Claire's Campaign, external, found about half of the 100 GPs surveyed across Wales felt limited consultation time was a major concern. A third also had concerns about "over-referring" people for further testing to rule out cancers, given hospitals are already overstretched.
Currently, 95% of patients put on the suspected cancer pathway are later told they do not have cancer. But doctors said teasing out the cancer cases at an early stage could be challenging when symptoms such as bloating are hard to distinguish from benign conditions including irritable bowel syndrome. Naseem said the pressure from the Welsh government was to "offer more appointments to the patient, rather than about the quality of the treatment".
Lowri Griffiths of Tenovus said incidence and mortality rates for gynaecological cancers in Wales were higher than the UK average - something she added the Welsh government needed "to get to grips with". Pledges to increase GP numbers were promising, she said, "but unless we address both the primary care setting and the hospital setting, the system won't work". Naseem said many women's health issues may require an internal examination, which requires time to be done "in an empathetic and sensitive way".
She added: "I'm working in a very diverse community, also in a deprived community, where uptake of screening is already low." She said in communities where myths existed around screening, time is also required to explain what is involved and allay fears and potentially work with interpreters. Dr Kathrin Thomas, a former GP and public health specialist, got involved in Claire's Campaign when her friend Claire O'Shea was given a late diagnosis for a gynaecological cancer. Claire, from Cardiff, died last year, aged 42.
Thomas said GP numbers in Wales had "almost flat-lined" while the workload had increased, especially in more disadvantaged areas where there were "fewer doctors, fewer nurses and the healthcare needs are much greater". She is also involved with Deep End Cymru - a network of GP practices in the most deprived areas. "We've got a big difference in the cancer experience in more deprived communities - cervical cancer in particular," she said.
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