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Gerada attacks consortia referral management plans

By Ian Quinn

The chair of the RCGP has told MPs plans for consortia to performance manage practices under sweeping new referral management regimes will put patients at risk.

Dr Clare Gerada told the health committee inquiry on commissioning that the growth in compulsory referral management centres across the country was already causing ‘tensions'.

Under the Government's plans, consortia will have a large degree of control over GP referrals with GPs set to be legally bound to sign up to their plans.

She warned the new powers to be handed to consortia to report practices with high rates of referral to the new NHS Commissioning Board risked a conflict of interest between what was best for saving money and what was best for patients.

‘My members are sending me comments about the tensions it is creating because they don't believe these things are in the patients' interest. For example, the mandatory use of referral management.

'What we have at the moment are referral rates and prescribing rates. We need a robust means of measuring performance.

‘Clearly there are some doctors who prescribe incredibly badly but if we use referral management for everything we may inadvertently delay cancer diagnosis and we may inadvertently under-refer.

‘Stopping patients going to hospital will become the priority for consortia to release funds. We have to be careful that we are not performance managing GPs where patients are going to be put at risk.'

Dr Gerada also expressed concerns over the potential for conflict of interest among consortia, especially among smaller consortia, where one large practice could wield huge power because it had a large proportion of patients in the consortia on its list.

‘This is a real issue for smaller consortia. I wouldn't like my performance to be controlled by the practice up the road.'

Dr Clare Gerada: Consortia referral management will cause 'tensions'

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