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Better late then never: GP startled by ancient cheque

Patients are dying on waiting lists because the new GMS contract is forcing GPs to swamp echocardiography services, a cardiologist claims.

Referral rates for echo are spiralling as GPs chase points for confirming heart failure ­ tipping services into 'crisis' and bringing GPs into conflict with cardiologists.

GPs blamed lack of investment for a 'postcode lottery' in echo services and insisted they had to be allowed to exception report if local shortages made referral impossible.

Consultant cardiologist Dr Adrian Brodison of the Royal Lancaster Infirmary said the contract was combining with staff shortages to put acute pressure on echocardiography services.

'A crisis situation will happen and some patients will die as a result of not getting investigations,' he said, adding two of his patients had already died while waiting for echo.

Dr Gregor Purdie, chair of Dumfries and Galloway LMC, said consultants were getting 'cheesed off with the number of referrals made to get points'.

The quality framework sets a 90 per cent target for echo-cardiography confirmation, worth an average £450.

Dr Ahmet Fuat, a GP in Darlington with a special interest in heart failure, confirmed referrals had increased since April and said he 'could see why cardiologists get twitchy'.

But he said GPs were acting in good faith and following Government advice.

A meta-analysis in the latest edition of the European Journal of Heart Failure reinforced the need for echocardiography confirmation, find- ing 12-lead ECG was inadequate for diagnosis.

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