Looking for further support?

Practices and PCNs should refer to the guidance notes and resources on this website for The NEW Cheshire and Merseyside pathway for urgent suspected LGI cancer, incorporating FIT. Do not use NICE guidelines. 

There is a change to the threshold for screening FIT tests from Quarter 4 2026/27. The threshold will be reduced from 120ug to 80ug.


CAN-04


Percentage of lower gastrointestinal urgent suspected cancer referrals accompanied by a faecal immunochemical test result, with the result recorded in the twenty-one days leading up to the referral.
Of the denominator, the number accompanied by a faecal immune chemical test, with the result recorded in the twenty one days leading up to the referral.


Standard Quantitative; Upwards; 22; 65% (LT) / 80% (UT); GPES 


Practices must ensure that all 2ww/urgent suspected cancer referrals are coded (the C&M safety netting template will do this for you)


Please note that in some areas across Cheshire and Merseyside the FIT result from the local lab does not come back to the practice with a code attached.

  • Practices need to check that their FIT results have an attached Snomed code
  • If there is no code this will affect your IIF target achievement

In the first instance please contact your local IT support to assist you. In addition: 


 

The 2026/27 PCN DES states that PCNs should work to promote the use of pathways which support and streamline diagnosis and referral practice in primary care, including Teledermatology to support faster skin cancer referrals. These slides provide an update for Cheshire and Merseyside.

The 2026/27 PCN DES states that PCNs should work to promote the use of pathways which support and streamline diagnosis and referral practice in primary care, including Non-Specific Symptom (NSS) pathways for patients with symptoms that could indicate cancer but who do not fit clearly into a single Urgent Suspected Cancer referral pathway. These slides provide an update for Cheshire and Merseyside.

About the guidance:

This guidance is not a clinical guideline.

It provides 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.

The guidance supports the first phase of delivery and is aimed at and of interest to healthcare professionals in primary care, secondary care and service commissioners. It builds on Direct access to diagnostic tests for cancer (2012).

It covers the following diagnostic tests, which all GPs should have access to as a minimum:

  • chest X-ray
  • CT chest
  • CT abdomen and pelvis
  • ultrasound abdomen and pelvis
  • brain MRI.

It also details expectations around wait and turnaround times for direct access referrals made for this cohort.

NHS England » Urgent GP direct access to diagnostic services for people with symptoms not meeting the threshold for an urgent suspected cancer referral

View our referral quality page.

View our PRACTICE Dashboard page

View our Health Inequalities page

View our Lung Cancer Screening Programme

View our Programme of Cancer Early Diagnosis Education (PrOCEDE): Made by GP's for GP's and Resident Doctors