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GPC forces trust to scrap incentives to cut referrals

A PCT has been forced to abandon plans to pay GPs rewards for cutting emergency referrals after the GPC condemned the scheme as 'immoral'.

South Worcestershire PCT wanted to offer financial incentives to GPs who cut emergency referral rates to the local average.

GPC prescribing chair Dr Peter Fellows said it scuppered the scheme as soon as it heard of the plans. 'The trust was rewarding GPs using an incentive scheme for low referral rates, which we challenged,' he said. 'We thought it was totally immoral and unethical.'

Dr Roger Ingles, chair of Worcester LMC ­ which reported the move to the GPC ­ said the scheme would have 'chipped away' at the public's perception of GPs' integrity. 'It looks as if your clinical judgment is affected by cash,' he said.

A spokeswoman for the PCT said the proposal aimed to 'address the continuing pressures at our local acute trust by looking at both admission prevention and earlier discharge'. She added: 'As the majority opinion of GPs was that this would not be the best way of tackling this issue,

the proposal was withdrawn.'

The row has echoes of the bitter dispute that erupted between the Government and the GPC in 2000 when Prime Minister Tony Blair accused GPs of 'misusing' emergency referrals to jump waiting lists.

The Government last year asked its Emergency Care Collaborative to cut unnecessary admissions.

But Dr Paul Zollinger-Read, GP lead of the Government's national patient access team, said it was 'inappropriate' to penalise GPs for high emergency referral rates.

'On the whole it's social demographics that are reflected in referral rates rather than individual doctors' skills,' said Dr Zollinger-Read, a GP in Braintree, Essex. 'Emergency referrals are even more strongly correlated with social factors. I don't think this is a primary care issue but is due to the thresholds of admitting doctors in secondary care.'

NHS Alliance professional executive committee chair Dr David Jenner said it was wrong to blame emergency referral rates on individuals as many happened out of hours.

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