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Direct Access Diagnostics for primary care

Direct Access Diagnostics (DAD) is when a test is performed and primary care retain clinical responsibility throughout, including acting on the result.

Significant numbers of patients continue to be diagnosed at a late stage in England and our cancer outcomes are behind the lowest in Europe. The current NHS Long Term Plan sets out a commitment to achieve earlier diagnosis for cancer patients. Our GPs are often the first medical professional to see a patient with symptoms suspicious of cancer and so  supporting pathways to give direct access to GPs for diagnostic tests will help them diagnose or exclude cancer earlier (often referred to as Direct Access Diagnostics).

Historically there have been significant barriers to implementing Direct Access Diagnostics (DAD) in London cancer services but the Transforming Cancer Services – Early Diagnosis Team aim to bring together key leaders in London to ensure there is equitable roll of DAD across all boroughs of London.

In September 2023, NHS England published updated advice on the use of urgent direct access referrals to specific diagnostic tests where the threshold for referral under the urgent suspected cancer referral pathway – to a specialist or for urgent GP direct access testing – as outlined by National Institute for Health and Care Excellence guideline NG12 is not met.

Download the presentation on DAD Commissioning in London to find out more.