From GP Referral to Brain Scan: Improving the Pathway for Suspected Brain Tumours
Lancashire Teaching Hospitals introduced a direct GP‑to‑MRI brain scan pathway to speed up diagnosis for patients with symptoms that might suggest brain cancer. The team presented this work as an e-poster at the Association of British Neurologists Annual Conference in Birmingham, UK, 6-8 May 2026. Reviewing almost 2,800 scans over eight years showed the pathway is safe and effective: most patients were quickly reassured with normal or non‑serious findings, serious conditions were identified earlier, and unnecessary neurology outpatient appointments were avoided. A weekly specialist review ensured the right patients were fast‑tracked to neurology or neuro‑oncology, while pilot AI tools showed promise in supporting future pathway improvements.
Diagnosing conditions affecting the brain and nervous system can be challenging. Traditionally, patients with symptoms that might suggest a brain tumour—such as new or worsening headaches—were first referred to a neurology clinic. Only after this specialist review would brain imaging be requested. While safe, this process could add delays and place pressure on already busy outpatient services.
In November 2017, Lancashire Teaching Hospitals introduced an enhanced “direct-to-scan” MRI pathway. This new approach allows GPs to refer selected patients straight for brain imaging, without waiting for a neurology appointment first. The aim is simple: speed up diagnosis, identify serious conditions earlier, and ensure specialist time is focused where it is most needed.
How the pathway works
Patients referred by their GP undergo a high-quality brain MRI (or occasionally CT) scan, usually completed within a short appointment. Each scan is reported by a neuroradiologist and then reviewed in a weekly “mini‑MDT” (multidisciplinary team) meeting involving a neurologist and neuroradiologist.
If the scan suggests cancer, the patient can be fast‑tracked directly into the neuro‑oncology MDT. Where findings are non‑urgent or incidental, GPs receive clear advice and guidance, including when neurology referral is or isn’t needed.
What we reviewed
The team analysed nearly 2,800 scans performed through this pathway over an eight‑year period. A detailed audit of 10% of cases checked presenting symptoms, scan findings and outcomes. In parallel, a pilot artificial intelligence tool (natural language processing) was tested to help identify common scan findings efficiently across the whole dataset.
What we found
Headache was by far the most common symptom prompting referral. Reassuringly, almost one‑third of scans were completely normal. Many others showed common, non‑cancerous findings such as age‑related small vessel changes.
Importantly, serious conditions—such as brain tumours, metastases and inflammatory diseases—were identified promptly. When necessary, patients were directed quickly to the right specialist team.
Crucially, the pathway avoided unnecessary neurology outpatient appointments for the majority of patients, while ensuring those who genuinely needed specialist review were identified efficiently. A small but important group with unexpected findings, such as demyelination, were able to access neurology care faster than they would have otherwise.
Why this matters
This work shows that a carefully designed direct MRI pathway is safe, efficient and patient‑centred. It supports GPs, reassures patients more quickly, reduces pressure on outpatient services and enables earlier diagnosis of serious neurological disease.
Looking ahead, further refinement of the AI tools may help streamline the pathway even more. The approach also has potential to be extended beyond suspected cancer to other neurological conditions.
At Lancashire Neuroscience, this work reflects our commitment to innovation, collaboration and better outcomes for patients across the region.