Patients who possibly have cancer will initially have their symptoms examined over the telephone due to the disruption caused by the coronavirus outbreak.

As part of a drive to keep non-urgent hospital visits to a minimum, most patients will have to verbally describe suspicious lumps, sudden weight loss or other indicators in their first specialist consultation.

Taking into account the wait to see a GP, then the fortnight specialist referral time, that could mean a lag of several weeks from someone first feeling unwell or noticing symptoms to seeing an oncologist in person.

The new measures form part of emergency NHS guidance published last Wednesday to reflect the crisis faced by the health service due to coronavirus.

They follow rules issues two days previously which instruct cancer departments to ration treatment to those patients most likely to survive if hospitals become overwhelmed.

On Monday, The Telegraph revealed that patients at the Royal Free hospital, in north London, were having their treatment postponed for months. The following day, Barking, Havering and Redbridge NHS Trust, in east London, became the first in the country to announce the postponement of all routine cancer surgery and chemotherapy.

The guidance also raises the possibility that urgent referrals from GPs could be downgraded or avoided due to lack of capacity.

“It is important that, during the response to the Covid-19 pandemic, appropriate clinical priority is given in the diagnosis and treatment of cancer, and we understand that service provision may need to flex as part of infection control,” the document says. 

On Saturday, the National Institute for Health and Care Excellence issued new guidance encouraging patients who have already embarked on cancer treatment to consider suspending it because of their added risk from coronavirus.

Dr Rosie Loftus, the chief medical officer at Macmillan Cancer Support, said: “We understand this is a particularly anxious time for people awaiting hospital appointments, and we also recognise that these are exceptional circumstances for the NHS.

“Clinicians are prioritising telephone appointments and referring straight for tests and investigations where appropriate to reduce the risk of infection.

“We will continue to support the hard-working professionals who are doing all they can to ensure that critical diagnosis and treatment continues so that people with cancer don’t miss out.”

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