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Independents' Day

But trusts misuse GPSIs says report

PCTs have rushed to implement GPSI services as a cost-cutting measure without planning to ensure they work effectively, a new report warns.

Researchers at the Centre for Health Economics in York uncovered a series of concerns over GPSI services, including unclear arrangements for clinical governance, poor links with secondary care and questionable cost-effectiveness.

The interview-based research found that in at least one instance referrals to secondary care had shot up after introduction of a GPSI service.

Study leader Dr Andrew Sweet, senior research fellow at the centre, said there was a role for GPSIs but it needed to be more clearly defined within PCT and hospital services.

'We really do need some standards and PCTs have been slow to recognise that we need appropriate criteria. There's not been a clear demarcation of the boundary and competencies. You can't just put a GPSI in place and think that's going to resolve the problem.'

Specialists warned incentivising PCTs to reduce referrals to secondary care could have disastrous consequences without proper planning.

One dermatologist who wanted to remain anonymous told Pulse: 'At the moment due to financial pressures PCTs are moving resources from some hospitals and there's a great risk mistakes will occur. We do need specialist provision as well [as GPSIs].'

Dr John Adams, a GPSI in dermatology in Cheadle, Cheshire, said: 'When it works, it works extremely well, but you do have to sort it out in advance. You do need guidelines on what the

GPSI can do and what should go straight to secondary care.'

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