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GP commissioners impose locum referrals ‘ban’

Exclusive GP commissioners are set to impose a ‘referral ban' on locums in a bid to drive down hospital referral rates, under controversial plans tabled by a clinical commissioning group (CCG).

Board papers from Southwark Clinical Commissioning Committee reveal plans to launch ‘a ban on GP locum referrals' in a bid to tackle ‘significant over activity' by local GP practices. The papers show that the CCG hopes to ‘launch the ban', which will see GP partners asked to police locum referrals, at locality meetings being held this month.

But sessional GP leaders attacked the ‘patronising' plans – which they said would isolate locums by implying that they have lower clinical competence than GP partners.

The papers state: ‘Month 5 GP practice level activity reports indicating the significant overactivity will be sent out on Monday followed up by visits to practices. AB stated that he will discuss [the] request re a ban on GP locum referrals…and then hopefully launch the ban at the locality meetings.'

Sessional GP leaders agreed that peer review of referrals could be a positive step, but warned that singling out locums would ‘disenfranchise' sessional doctors and see them ‘set up to fail.'

Dr Steven Bassett, deputy chair of the BMA sessional GPs subcommittee and a GP in Swansea, South Wales, said: ‘All GPs need to look at our referrals, but to single out locums and use of terms like "ban" on referrals is unacceptable and unjustified. The contractual status of a doctor has no bearing on the clinical competence of practitioner.'

Dr Richard Fieldhouse, chief executive of the National Association of Sessional GPs and a locum GP in Chichester, said: ‘GPs all working together on referrals can be sensible but to single out locums is patronising and sends the message that GP partners are somehow above sessional doctors.'

‘You will end up with a lot of disenfranchised locums who are being set up to fail.'

GPs from Southwark Clinical Commissioning Committee were unavailable for comment.

In a statement, the CCG said: ‘The suggestion refers to GP partners quality assuring referrals by locum GPs to ensure referrals are directed to the most appropriate service. ‘

‘This approach will be discussed with the chair, vice chair of the Southwark Clinical Commissioning Committee and the Local Medical Committee Chair before any implementation.'