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GPs go forth

Incentivising practices to cut referrals ‘shocking practice’, says cancer chief

Paying practices to reduce the number of cancer referrals they make amounts to ‘shocking practice’ that runs counter to national policy encouraging GPs to refer patients as soon as possible, the Government’s chief advisor on cancer services has insisted.

The comments from Harpal Kumar, chief executive of Cancer Research UK and the head of the Government’s independent Cancer Taskforce, came after Pulse uncovered examples of CCGs running incentive schemes to cut GP referrals including those for urgent investigation of suspected cancer.

Speaking after presenting a talk to the RCGP’s annual conference in Glasgow on Friday, Mr Kumar said: ‘My own view is that if that is happening it is shocking practice, it’s very bad practice and it needs to stop.’

He added: ’If a patient is presenting with symptoms that might be cancer, we should be testing for those, doing that quickly.’

Mr Kumar said that such incentive schemes would end up costing the NHS more rather than saving money.

‘It’s much more cost-effective to do things that way, [rather] than to have late diagnoses with poorer outcomes and much more expensive treatment - we are kidding ourselves if we think that by reducing the number of suspected cancer referrals we’re going to be saving money.’

Mr Kumar stressed that under the Cancer Taskforce plans for improving cancer outcomes - which include a major push on earlier diagnosis that the Government recently backed with the promise of an extra £300m a year for diagnostic services - ‘the direction must be that we should be doing more investigative testing for cancer’.

Asked if the investment was enough to ensure services could cope with the expected increase in referrals, he added that he was ‘satisified the will is there’ from the Government and NHS England, but concerned over ‘how quickly we can get the workforce in place’.

Mr Kumar said: ’The Government has already announced an extra £300m a year for diagnostic testing - what we now do need to do is deliver that. I think the critical limiting factor is going to be how quickly we can get the workforce - we don’t only have a shortage of GPs, we have shortage of radiologists, radiographers and to a lesser extent pathologists.

’But without that whole team of people in enough capacity we’re not going to be able to deliver all this. For me the issue is now about how quickly we can get the workforce in place.’

Pulse revealed that NHS England has been in contact with the CCGs that are offering incentives to practices for cutting cancer referrals.



Readers' comments (5)

  • most GPs entered the profession for the right reasons. if the investigations/referrals are needed : it will be done.

    the worrying bit is CCGs are suppose to be led by GPs: its depressing to know the GP leds in CCG allowed this to even be passed as an incentive scheme. The ethos of these CCGs needs to be checked again.

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  • Over the past 5 years it seems as though reducing referrals/ admissions/ A+E attendances has overtaken patients' best interests as the most important factor in planning healthcare.

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  • The government need to invest in NHS.
    These idiots don't understand and hence they come up with bizarre strategies-incentivising GPs for less referrals.
    Try to solve this before making GPs work 7 days a week.Mr Hunt.

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  • These decisions are made by CCGs with blessings from NHSE and the Govt - so shocking as it may seem, we'll continue to have more of this criminal behaviour because both are above law.

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  • Bravo Mr Kumar!

    You have the right idea-- if a little naive. It always costs more to provide good health care. A late diagnosis is tragic--but cost effective.

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