ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2018
GPs' understanding and practice of safety netting for potential cancer presentations: a qualitative study in primary care.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Family physician perspectives on managing indirect patient care activities in the electronic inbox: a systematic mixed studies review.Family practice · 2025Pooled it
- The implementation challenge of computerised clinical decision support systems for the detection of disease in primary care: systematic review and recommendations.Implementation science : IS · 2025Pooled it
- Urgent, but Not Certain: A Systematic Environmental Scan and Content Analysis of Publicly Available Patient Information for Suspected-Cancer Referral in England.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026Article
- Exploration of Physiotherapists' Understanding and Application of Safety Netting Procedures in France-A Qualitative Study.Musculoskeletal care · 2026Article
- The Paused Pathway: Teaching Investigative Consent when Cancer Investigation Stalls.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026Article
- Educational Interventions to Reduce Cancer Diagnostic Delays in Primary Care: A Scoping Review.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026Review
- Role of communicating diagnostic uncertainty in the safety-netting process: insights from a vignette study.BMJ quality & safety · 2024Article
- 'ThinkCancer!': randomised feasibility trial of a novel practice-based early cancer diagnosis intervention.BJGP open · 2024Article
- How is diagnostic uncertainty communicated and managed in real world primary care settings?BMC primary care · 2024Article
- Safety-netting strategies for primary and emergency care: a codesign study with patients, carers and clinicians in Sweden.BMJ open · 2024Article
- Hidden systems in primary care cancer detection: an embedded qualitative intervention development study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Patients' and clinicians' views on the appropriate use of safety-netting advice in consultations-an interview study from Sweden.BMJ open · 2023Article
- Electronic safety-netting tool features considered important by UK general practice staff: an interview and Delphi consensus study.BJGP open · 2023Article
- Healthcare use and clinical investigations before a diagnosis of ovarian cancer: a register-based study in Denmark.BMC primary care · 2023Observational
- SAFETY NETTING CONCEPT IN PRIMARY CARE CONSULTATION.Annals of Ibadan postgraduate medicine · 2023Article
- Using an electronic safety netting tool designed to improve safety with respect to cancer referral in primary care: a qualitative service evaluation using rapid appraisal methods.BMJ open quality · 2023Article
- Safety netting advice for respiratory tract infections in out-of-hours primary care: A qualitative analysis of consultation videos.The European journal of general practice · 2022Article
- What are the similarities and differences in lung cancer symptom appraisal and help-seeking according to smoking status? A qualitative study with lung cancer patients.Psycho-oncology · 2022Article
- Harnessing the Electronic Health Care Record to Optimize Patient Safety in Primary Care: Framework for Evaluating e-Safety-Netting Tools.JMIR medical informatics · 2022Article
- Optimising GPs' communication of advice to facilitate patients' self-care and prompt follow-up when the diagnosis is uncertain: a realist review of 'safety-netting' in primary care.BMJ quality & safety · 2022Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundSafety netting is a diagnostic strategy used in UK primary care to ensure patients are monitored until their symptoms or signs are explained. Despite being recommended in cancer diagnosis guidelines, little evidence exists about which components are effective and feasible in modern-day primary care.
aimTo understand the reality of safety netting for cancer in contemporary primary care. DESIGN AND
settingA qualitative study of GPs in Oxfordshire primary care.
methodIn-depth interviews with a purposive sample of 25 qualified GPs were undertaken. Interviews were recorded and transcribed verbatim, and analysed thematically using constant comparison.
resultsGPs revealed uncertainty about which aspects of clinical practice are considered safety netting. They use bespoke personal strategies, often developed from past mistakes, without knowledge of their colleagues' practice. Safety netting varied according to the perceived risk of cancer, the perceived reliability of each patient to follow advice, GP working patterns, and time pressures. Increasing workload, short appointments, and a reluctance to overburden hospital systems or create unnecessary patient anxiety have together led to a strategy of selective active follow-up of patients perceived to be at higher risk of cancer or less able to act autonomously. This left patients with low-risk-but-not-no-risk symptoms of cancer with less robust or absent safety netting.
conclusionGPs would benefit from clearer guidance on which aspects of clinical practice contribute to effective safety netting for cancer. Practice systems that enable active follow-up of patients with low-risk-but-not-no-risk symptoms, which could represent malignancy, could reduce delays in cancer diagnosis without increasing GP workload.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.