Transformation Directorate

An AI support tool to help healthcare professionals in primary care to identify patients at risk of cancer earlier

Early diagnosis of cancer could save thousands of lives. It is therefore vital to ensure all patients at risk of cancer are identified and referred to the appropriate service as quickly as possible. Artificial intelligence (AI) can support such a service.


There is no single identifiable symptom or test that can alert GPs to a potential cancer diagnosis. It is often difficult and time consuming for GPs to be able to identify potential signs of cancer early.


A new diagnostic tool that helps to detect cancer in its earliest and most curable stages has been rolled out to more than 1000 GP practices.

The tool is in line with the NHS Long Term Plan’s ambition to support early cancer diagnosis and to support the primary care cancer targets outlined in the primary care network (PCN) directed enhanced services (DES) framework and the quality and outcomes framework (QOF).

It provides GPs with the ability to check combinations of signs, symptoms and risk factors in an easy-to-use format. The use of AI mapped with the latest NICE guidelines and other evidence helps to improve the quality of care and offer a smoother referral process in primary care.

Solution and impact

Designed to be used within a GP consultation, C the Signs supports clinicians in recommending what investigations or referrals the patient may need. GPs can search by symptom or area of the body affected and will then be shown each diagnostic pathway.

The content can also be adapted to provide information on what support is available locally, for example, any direct access diagnostics or information on a best practice pathway.

The C the Signs team is currently working in partnership with 4 cancer alliances and 27 clinical commissioning groups (CCGs) in England. A pilot run in the east of England shows that there was an increased cancer detection rate of 6.4% in primary care (compared with 0.21% in non-pilot sites in the east of England).


  • Accessible on desktop computers, mobile phones and through the patient’s electronic health record
  • GPs can access the tool during the consultation to identify which referrals and investigations the patient needs


  • Covers all cancer pathways
  • With the use of evidenced-based risk assessment, signposts healthcare professionals to which cancer(s) a patient is at risk of developing and what test or referral they need
  • Uses validated national, regional and local guidelines to ensure all pathways and evidence are kept up to date
  • Pathways are configured to the CCG and local Trusts, including 2-week wait pathways, direct access diagnostic and straight-to-test pathways
  • All 2-week wait referral forms are digitised and pre-populated, ensuring patients are eligible and forms are fully completed
  • Each practice has a dashboard for active surveillance of patients on a cancer pathway, including cancer care reviews and stratified follow-up
  • A database of validated, evidence-based patient information leaflets in multiple languages. These pop up once corresponding cancer pathways are recommended and can be printed or texted to the patient. This can be configured to include local leaflets, resources and services
  • Real-time view of referral activity, pathway utilisation, and which tumours are being identified. This can help better-informed service provision and modelling of demand
  • C the Signs reports on impact and outcome of cancer referral rates, detection rates, 2-week wait activity, 14 and 62-day standards and A&E diagnosis rates. The tool can support practices and PCNs to see their real-time cancer performance data


To be used within a GP consultation, C the Signs is integrated with EMIS, SystmOne and Vision. All patient assessments, safety netting and tracking of cancer patients is saved and coded back into the patient records.

Find out more

Download the RM partners cancer alliance evaluation report (PDF, 1.39MB)

Download the evaluation report by York Health Economics Consortium (PDF, 303 KB)

Key contact

Dr Bhavagaya Bakshi, NHS GP, Co-founder and Chief Executive at C the Signs