Supporting early diagnosis in primary care



Symbol of diagnosis

This new guide is aimed at general practitioners, radiology departments, commissioners and providers

This good practice guide is a collaborative effort between the Royal College of Radiologists, the Royal College of General Practitioners, and the Society and College of Radiographers.

It has been developed to improve imaging services in the early stages of illness, particularly in primary care, by building strong partnerships between diagnostic imaging departments and primary care providers. The guide is aimed at general practitioners, radiology departments, commissioners and providers.

Measuring quality of clinical imaging services

Patient outcomes, safety, experience, and efficiency of the service, are all criteria by which the quality of clinical imaging services can be measured. Specifically, however, this guide states that there are five areas which need particular evaluation, and these are:

Measuring tapes

The guide includes the criteria by which the quality of clinical imaging services can be measured

  1. Patient access – how close are the services to the patients? How quickly can the test be arranged for the patient, and when will the results be available? The sooner the better so that a diagnosis can be made and the treatment started.
  2. Patient information – clear and comprehensive information about the test should be provided to the patient so that an informed choice can be made.
  3. GP/referrer access – a simple route to requesting imaging services must be in place for staff working in primary care so that there are no delays in the process. Also, follow-up access to enable clinical discussion must be available so that GPs can discuss any issues with members of the imaging team.
  4. Clinically appropriate imaging – as multiple providers emerge, there is a risk of inappropriate imaging and this guide suggests that commissioners to make sure that any service that they commission includes education/audit programmes, so that all staff understand which is the best service for their patient.
  5. Integration into pathways of care – secure and reliable communication channels must be in place where there is more than one provider so that the patient pathway remains seamless.

Communication and education

People talking

The guide concludes with a brief description of commissioning issues and a list of useful references.

As with all new services and partnerships, effective communication is vital, so that all staff understand what is expected, and who needs to know what. The patient needs to be at the centre of the care pathway, and all the departments involved need to work to that centre.

This guide makes recommendations throughout, including this section, and proposes regular multidisciplinary meetings to educate, feedback, and support integrated relationships. It also suggests regular audit so that services can continually improve.


Primary care staff should read this guide and see how they can apply the recommendations. This is an ideal time to do this as organisations are still setting up in the new NHS, and relationships are still being built. This document is so important because early diagnosis can make such a difference to the patient care pathway and ultimately their experience of health care services. It also can have a significant impact on savings for the NHS as if a condition is diagnosed in the early stages, less radical treatment may be possible, which will be better for the patient and for the service as a whole.


Quality imaging services for primary care: a good practice guide (PDF)
Royal College of General Practitioners, Society and College of Radiographers, Royal College of Radiologists
May 2013

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Caroline De Brún

Caroline De Brún

Caroline has been a medical librarian in a variety of NHS and academic roles since 1999, working in academic, primary and secondary care settings, service improvement, knowledge management, and on several high profile national projects. She has a PhD in Computing and currently develops resources to support evidence-based cost and quality, including QIPP @lert, a blog highlighting key reports from health care and other sectors related to service improvement and QIPP (Quality, Innovation, Productivity, Prevention). She also delivers training and resources to support evidence identification and appraisal for cost, quality, service improvement, and leadership. She is co-author of the Searching Skills Toolkit, which aims to support health professionals' searching for best quality clinical and non-clinical evidence. Her research interests are health management, commissioning, public health, consumer health information literacy, and knowledge management. She currently works as a Knowledge and Evidence Specialist for Public Health England, and works on the Commissioning Elf in her spare time.

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