GP Direct Access imaging in North Central London is being affected by the rise in Covid admissions to local providers and some services have been temporarily restricted or paused.

Please see the diagnostic services updates on the NCL Covid-19 website to stay abreast of the rapidly changing situation.


Area specific guidance for Islington

GPs can refer direct to hospitals for urgent diagnotics and are encouraged to consider this instead of 2WW. The table detailing direct access imaging current provision (see Downloads, right) shows where to refer. Please note: this is a live table and will be updated as services change during the recovery period.


GP direct-access imaging service update (7 October 2020): Suspected cancer referrals move to single NCL referral form

GPs will now be able to request the following direct-access investigations for suspected cancer at any provider trust using a single referral form


  • University College London Hospitals
  • Royal Free London
  • North Middlesex University Hospital
  • Whittington Health

Imaging modalities

  • Abdominal USS (Suspected Gall bladder or Liver Cancer) 
  • MRI/(CT if MR contraindicated e.g. pacemaker)(Suspected Brain and CNS Cancer)
  • CT abdomen (Suspected Pancreatic Cancer)
  • CXR (Suspected Lung Cancer)
  • Pelvic USS (Suspected Endometrial Cancer) (Royal Free, North Middx, Whittington Hospital only. For Gynae USS at UCLH please use the 2WW pathway)
  • Testicular USS (Suspected Testicular Cancer)

If you would like to use these services you must use the EMIS form found in EMIS > ISL Global Documents > Imaging > Urgent Direct Access Imaging Request Form (adult and paed) - Suspected Cancer - NCL FORM

Please note: requests via t-Quest will no longer be accepted and will be rejected at the Royal Free. (tQuest development is in process however.)

Only request an investigation urgently if the patient meets the NICE criteria outlined in NG12 Guidelines. Radiology services are under considerable strain, and a request to undertake a test within two weeks should be clearly justifiable on clinical grounds as an investigation for possible cancer. These services should be requested sparingly, to support care for those patients for whom an imaging diagnostic is essential.

In the case of a positive result, in line with the Royal College of Radiologists guidelines, in which a scan is likely to indicate a potential cancer, the imaging department will initiate a referral onto the trust’s own 2WW pathway. GPs will need to add this patient to their 2WW safety netting system to ensure they have been seen within two weeks.


GP direct-access imaging service update (28 August 2020): Referral pathways during post-Covid recovery period

GP direct-access imaging services in North Central London (NCL) have reopened for referrals – in a phased way – to allow trusts to work through their Covid backlogs in a systematic way. Part of this has involved a comprehensive reprioritisation exercise, which many GPs in NCL are supporting, thanks go to GPs for assisting with this process.

Please see updated table (see Downloads, right) showing current imaging provision across NCL.

Please note: this is a live table and will be updated as services change during the recovery period. We are working hard with providers to restore full services as soon as possible.

All GPs are required to ensure the following actions are undertaken for their direct-access imaging requests.

Red, Amber, Green

Prioritisation of all new imaging referrals as red, amber or green must be completed, using the criteria below. This must be clearly stated in the request details/referral forms. Incomplete referrals will be returned for clarification.

  • RED – HIGH PRIORITY: Cancer [2WW referral, cancer pathway, suspected cancer and any patient with a cancer history] and non-cancer critical referrals. Imaging within two weeks.
  • AMBER – MEDIUM PRIORITY: No known cancer but clinical indication indicates the scan can’t be deferred. Condition may cause harm and imaging is expected to change management. Imaging as soon as possible but may take up to six weeks.
  • GREEN – ROUTINE/LOW PRIORITY. Condition unlikely to cause significant harm and can wait for assessment. Imaging as soon as possible but may take up to three to six months. Planned follow up falls within this group scanned at interval defined by clinical information provided.

In addition, please note for shielded patients:

If a request for a shielded patient is marked as red or amber it is important that the patient understands that they must attend for the imaging examination despite their shielded status. Please can the referring GP remember to discuss this with the patient.

If you do not want a patient to attend for the imaging examination because they are shielded it is best that you do not request the imaging examination until you are happy for the patient to leave home. Please do not put “book after Covid-19” on the request form.


All imaging departments, both NHS and InHealth, will endeavour to scan all referrals as quickly as possible and the time frames indicated above are indicative turn-around times.

There is no change for MSK referrals in Islington and Haringey, please continue to use the MSK single point of access service in line with agreed pathways.

Please note: All GP direct-access MRI requests must comply with MRI referral criteria in place within Islington.


For the latest news on direct-access imaging, check diagnostic services updates on the NCL Covid-19 website. 



Area specific guidance for Camden

GPs can refer direct to hospitals for urgent diagnotics and are encouraged to consider this instead of 2WW. Click on tick below to go to relevant service page.


  CXR USS Gynae USS Abdomen CT Pancreas MRI Brain Upper GI Scope
RFL (RFH Site)

x x

RFL (B and CF Sites)

x x x