New scheme to cut hospital referrals is ‘risking lives’

Patients are being put at risk by controversial schemes to slash hospital treatment, doctors’ leaders warn.

Up to four in ten health trusts have set up ‘referral management centres’ where staff sift through GP letters.

These include requests for cancer scans, hip and knee replacements and as well as any appointments with a hospital specialist.

A report by the Royal College of GPs today warns that the schemes are unsafe, delaying care and undermining patients’ trust.

Up to four in ten health trusts have set up ‘referral management centres’ where staff sift through GP letters (stock image) 

The centres are normally manned by teams of admin workers who are supervised by a handful of nurses, GPs and hospital doctors to offer expertise.

But the College claims that these staff are rejecting patients’ treatment without having a proper understanding of their circumstances or medical history.

And if a GPs’ referral is rejected, they will have to go through the process of writing a new, stronger letter to be reassessed by the centre.

This delay could harm the patient – the College points out – particularly if they are awaiting a scan to check for cancer.

The centres have become increasingly popular amongst cost-cutting local health trusts, Clinical Commissioning Groups (CCGs).

But the College claims that they may actually be costing the NHS more to run than it would otherwise be spending on hospital scans and treatment.

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: ‘We can’t simply sit back and say nothing about some ethically-questionable initiatives that prioritise cost-savings over patient care.

She warned that the schemes were ‘undermining GPs’ professionalism and the decisions we make in the best interests of our patients, and in doing so erode the important trust our patients have in us.

Professor Helen Stokes-Lampard (pictured), chair of the Royal College of GPs, said: 'We can't simply sit back and say nothing about some ethically-questionable initiatives that prioritise cost-savings over patient care'

Professor Helen Stokes-Lampard (pictured), chair of the Royal College of GPs, said: ‘We can’t simply sit back and say nothing about some ethically-questionable initiatives that prioritise cost-savings over patient care’

‘Reviewing referrals is an important part of general practice, and a constructive part of professional development for GPs, but it must be proportionate, safe, and in the best interests of individual patient’s health outcomes.’

The report states: ‘There is no evidence that referral management, as defined here, is cost-effective or safe.

‘Moreover, there are significant ethical and professional concerns with these initiatives as they can undermine GP professionalism and patient choice.’

An investigation by the British Medical Journal last year found that 39 per cent of CCGs had set up a referral management centres.

Previous studies have found that in some areas including the Vale of York the centres were rejecting one in three GP referrals.

Many GPs were told their patients were ineligible for treatment or there was too little information to make a decision.

Dr Robina Shah, chair of the RCGP’s patient and carer partnership group, said the schemes were undermining patients’ trust in their doctor.

She said: ‘The relationship between a patient and their GP is unique in healthcare and built over time and we must approach any initiatives that threaten this with great caution.

‘I trust my GP to make the right decision about my referral – I don’t want bureaucracy getting in the way.’ 



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