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GPs face cap on number of vasectomy referrals

Exclusive GPs have been told they can only refer a limited number of patients to undergo vasectomy under plans to cut referral costs, Pulse can reveal.

Practices in Basildon and Brentwood CCG have been told they face a cap on how many GP referrals for vasectomy they can make in 2015/16, with three practices told they can refer just one patient each this year.

In a leaked letter, the CCG said it had made the decision after reviewing past ‘activity and spend’ on vasectomy services.

But GP leaders said the move was ridiculous and the CCG should consider reversing the plan.

The letter, dated 23 April, stated: ‘The CCG’s clinical executive committee has today reviewed the CCG’s activity and spend in relation to vasectomy services. Following this review the CCG clinical executive has taken the decision to cap the number of referrals for vasectomies each member practice can make.’

It added: ‘Please note that with immediate effect, CCG member practices can only refer to one of the CCG’s contracted providers of vasectomy services, and CEG have agreed that the number of reerrals will be capped.’

An accompanying list details the number of vasectomies each practice is permitted to refer in 2015/16 – ranging from one to 11 per practice.

It comes as CCGs in several areas are known to be drawing up plans to ration services such as hip and knee surgery, although Devon commissioners recently backed down on plans to restrict access to routine surgery for obese patients and smokers, and to ration hearing aids, following protests.

Dr Richard Vautrey, deputy chair of the GPC, said the CCG was risking unwanted pregnancies for the sake of a ‘few pounds’.

Dr Vautrey said: ‘This is a ridiculous short-term decision that could have huge long-term emotional and financial consequences to both families in the area that the CCG serves and to the wider NHS as other services have to pick up the pieces.

‘For the sake of saving a few pounds the CCG is taking the risk of a rise in unwanted pregnancies and all that means for individuals and families and they should seriously consider reversing this decision.’

Dr John Chisholm, former GPC chair and president of the Men’s Health Forum, agreed the approach could not be justified on clinical or cost-efficiency grounds.

Dr Chisholm said: ‘I believe it’s an inappropriate and wrong-headed decision that is neither in the interests of patient nor of GPs’ clinical decision making. At the worst obviously it could result in an unwanted pregnancy which would itself have undesirable consequences.

He added that the financial savings involved ‘would likely be pretty tiny’.

‘All CCGs are facing difficult decisions, nonetheless I think CCGs need to be concentrating on inappropriate use of resources and referrals rather than try to cap completely appropriate referrals,’ Dr Chisholm said.

Basildon and Brentwood CCG said in a statement: ‘The CCG has difficult decisions to make to ensure that it meets its statutory obligations. The decision has been taken to cap this years’ spend at the 2014-15 level. The number of referrals that each practice can make is based on their list size.

‘Referrals can be made to providers who were successful in obtaining a contract with the CCG following an open procurement process last year.’

Readers' comments (19)

  • This is ridiculous and I'm sure it would be susceptible to legal challenge.

    Being declined a medical procedure solely on the basis of someone having consulted before you is nonsense.

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  • Vinci Ho

    You see
    these are the issues this new government and its Health Secretary will have to face as far as oppositions and criticisms are concerned. Of course , it will say it has 'devoled' power to CCGs and CCGs would want to say they had no choice.
    I suppose anybody can do vasectomy for free is the 'best' provider or perhaps the Health Secretary should launch education programme to teach patients to do DIY vasectomy........

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  • Vinci you are right in that HMG will say "this is a local decision, blame the local GPs" whilst at the same time cutting the budget and forcing the CCG to make more cuts.

    This was obviously a poisoned chalice from the very beginning, I am still surprised how many of our lot were naive enough to sign up and think that they could magically make things better.

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  • This isnt saving money its just deferring in to the next year.

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  • Let common sense prevail

    Such a policy would not survive legal challenge. A policy not to fund any vasectomies might, but discriminating between patients on spurious (non-existent) grounds is clearly unlawful.

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  • Is vasectomy a choice? I can see the occasional medical need. Don't offer any and the CCGs problem goes away! (Ducks)

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  • Wonder if more women demand and will be referred for tubal ligation. More risk. Higher cost.
    Also if women can be referred but men can't is this gender discrimination.
    Has the CCG done an equality impact assessment?

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  • What do you think would happen if a CCG limited the number of people that were allowed to access the oral contraceptive pill?

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  • THE DAILY NUTTER will go mad......the "cunning Tories" have delegated NHS cost cutting to GPs/CCGs so that they can "finger point" to GPs as the "evil cost-cutters".
    THE DAILY NUTTER is a monstrous rag that uses brainwashing techniques on its readers-it is out of control and a menace to society.

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  • "Camoron" is keeping us sweating over whether his "enforcer" Hunt will be let loose on GPs....if so the next 5 years will be "like a fox Hunt" with "Camoron" and Hunt "blowing the bugle" and quaffing while GPs are endlessly "running for cover".

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