Fewer than half of all cancer cases are diagnosed through the suspected cancer urgent referral (2WW) pathways. Rapid Diagnostic Centres (RDCs) are set up for patients who don’t necessarily fit the criteria for a referral onto a specific 2WW pathway. They offer a diagnostic pathway for all patients with non-specific symptoms that could indicate cancer. See the Rapid Diagnostic Centres page for more details.

Advice and guidance is available and encouraged.

Area specific guidance for Barnet


Currently there is significant pressure on  endoscopy appointments across Royal Free sites which is having an impact on target two week and GP direct access referrals. The Royal Free is increasing capacity to deal with this issue however the CCG feels that potential cancer referrals should be prioritised. Therefore, with immediate effect, we are removing the requirement for direct access gastroscopy prior to a secondary care referral for upper GI symptoms in the absence of red flags. To ensure that the right people are being referred,  we have implemented the new dyspepsia pathway which was developed in collaboration with the Royal Free.

The RMS will be triaging against this pathway. Please pay particular attention to the duration of PPI treatment for each symptom and the necessary investigations required prior to referral. All referrals are to be sent via the RMS. Please do not send any direct access endoscopy referrals to the trust until further notice. Of course suspected cancer referrals continue to be referred in the usual manner.

Please remember the gastroenterology advice and guidance email for any related queries.

Email advice and or guidance  

 For advice and/or guidance it's very important that you include all the information from the bullet points so that the consultant gives the right advice, and you can be contacted by them if necessary to seek clarification. Any clinical queries concerning patients can be emailed to the following addresses for a consultant response within two working days:

Gastroenterology advice:

Please email from an account and include the following in your email:

The patient’s NHS number in the title of the email

Your name, role and contact details

The patient’s details (age, sex and RFL patient number, if known), relevant clinical history including results of any recent diagnostic tests within the relevant specialty

The clinical question(s) requiring an answer.

The response will be sent back to the email address from which it was sent. If your secretary is sending on your behalf, make sure she copies you in so that you also get the response. You can find more information about this service,  on the Royal Free website. For any other queries, please email

This service is exclusively for the use of clinical staff in GP practices (GPs, GPSTs and Nurse Practitioners) and not for routine administrative enquiries. 


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Last updated: May 13th, 2021
Review date: Dec 1st, 2021