Patient support, safety netting and diagnostic access guidance

A summary of the NICE recommendations on support for people with suspected cancer, safety netting and the diagnostic process.

Safety netting for patients with suspected cancer

Worrying about cancer and having tests can be a difficult time for patients, but there are many ways you can support patients with suspected cancer. NICE provides recommendations on patient support, safety netting and the diagnostic process. We have summarised the key recommendations below for you.

What does good practice involve?

There are many ways to improve safety netting for patients with suspected cancer. You can do all of the below:

1. Let the patient know why they are being referred

Explain to people who are being referred with suspected cancer that they are being referred to a cancer service. Reassure them, as appropriate, that most people referred will not have a diagnosis of cancer, and discuss potential alternative diagnoses with them.

2. Consider the patient's support needs while they wait for a referral appointment

When you refer a person with suspected cancer to a specialist service, assess what support they may need while they wait for their referral appointment. If the person needs support because of their personal circumstances, inform the specialist who is seeing them (with the person’s agreement).

3. Suggest a follow-up review with patients who are at risk

Advise people who may not meet the referral criteria to contact you again if their symptoms persist or progress.

4. Look for an alternative urgent referral pathway if required

If direct access to some tests is unavailable in your area, seek an alternative urgent referral pathway.

5. Give patients information about their possible diagnosis (if requested)

In accordance with the patient's wishes, it can be helpful to share information about the patient's possible diagnosis (both benign and malignant). Macmillan offers a range of online cancer information and booklets on many different cancer types, treatments and side effects, as well as emotional and practical guidance for people living with cancer. The information you give to people with suspected cancer, their families and/or carers should include:

  • how to obtain further information about the cancer they’re suspected of having (for example, the Macmillan Cancer Support website).
  • how to access any help they may need before their specialist appointment
  • what type of tests may be carried out and what will happen during these procedures.

6. Provide patients with information that is culturally and linguistically appropriate

When sharing information with patients, provide information that is culturally and linguistically appropriate for them, and take into account their literacy level. You can download Macmillan’s most commonly requested cancer information in different languages and formats.

7. Tell patients about the Macmillan Online Community

The Online Community is a place for people living with cancer to find others who understand what they are going through. It’s easy to join a conversation, read a blog or ask an expert for information. It's anonymous, free and open 24/7. Your patients can sign up at

You will note that some symptoms from NICE’s 2005 guidance for suspected cancer referral have been removed from this guidance update, although there may be no explicit recommendations, refer appropriately if clinical concern persists.