Overview for Healthcare Professionals
The Leeds Self-Request Chest X-Ray (CXR) Programme provides direct access to chest imaging for eligible patients with persistent chest symptoms, without the need for a prior GP consultation.
The pathway has been designed to support earlier diagnosis of lung cancer and other serious respiratory conditions, while reducing barriers to investigation and alleviating pressure on primary care.
Aims of the Programme
The service was established to:
- Facilitate earlier detection of lung cancer
- Reduce delays caused by barriers to GP access
- Provide a safe, governed alternative route to initial chest imaging
- Improve access for higher-risk and underserved populations
- Complement existing urgent suspected cancer (USC) pathways
By enabling patients to self-refer for a chest X-ray when experiencing persistent symptoms, the programme supports timely investigation at an earlier stage of disease.
Eligibility Criteria
Patients are eligible to use the Leeds self-request CXR service if they:
- Are aged 40 years or over
- Are registered with a Leeds GP
- Have not had a chest X-ray or CT chest scan within the previous three months
- Have experienced one or more relevant symptoms for longer than three weeks
Qualifying symptoms include:
- Persistent cough
- Fatigue
- Breathlessness
- Unexplained weight loss or loss of appetite
- Chest pain
- Haemoptysis
- A lump in the neck
These criteria ensure the pathway is targeted at those at increased risk while maintaining safe clinical parameters.
How the Pathway Operates
The service operates as a walk-in model, removing the need for a GP appointment prior to imaging.
Patients attend participating radiology departments and request access to the self-request CXR service. They complete an eligibility form prior to imaging to confirm they meet the agreed criteria.
Participating sites include:
- Leeds General Infirmary
- St James’s University Hospital
- Seacroft Hospital
- St George’s Centre
- Wharfedale Hospital
- Chapel Allerton Hospital
All imaging is reported by a specialist radiologist. Results are sent to the patient’s GP within 1–2 weeks, ensuring continuity of care within primary care records.
Where clinically indicated, patients are contacted directly by the hospital to arrange further investigation.
Clinical Governance and Safety-Netting
The programme includes:
- Clear inclusion and exclusion criteria
- Defined reporting pathways
- Communication of results via the patient’s registered GP
- Direct hospital follow-up for abnormal findings
- Safety-netting advice advising patients to contact their GP if symptoms persist, worsen, or if haemoptysis occurs
It is clearly communicated that a chest X-ray does not identify all serious pathology, and the service does not replace urgent clinical assessment where indicated.
System Impact
The Leeds model demonstrates how a self-request imaging pathway can:
- Increase diagnostic access without compromising governance
- Reduce GP appointment demand for initial imaging requests
- Support earlier-stage diagnosis
- Improve engagement among patients who may delay seeking help
The programme provides a scalable, replicable framework for other systems considering implementation of a similar intervention.
Healthcare professionals and system leaders can draw on the Leeds experience — including SOPs, operational criteria and communications materials — to inform safe and effective local adoption.