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GPs attack referral centre 'rationing'

Referral management centres are being set up by PCTs purely to ration care, save money and deny patients choice, the BMA is claiming, writes Helen Crump.

In a stinging attack, the association warned that referral management centres were leading to a breakdown in links between GPs and consultants.

Dr Hamish Meldrum, GPC chair, said in some parts of the country PCTs were operating 'mismanagement schemes'.

He said: 'Increasingly, we seem to be seeing cases where the prime reason for setting up these services has just been to cut costs.'

Dr Meldrum said it was difficult to establish who was making referral decisions in many regions using the centres.

The BMA has demanded the Government issue guidelines for trusts on referral management. 'Otherwise it will be completely undermining the agenda on patient choice,' Dr Meldrum said.

A BMA survey of LMCs found 'well over half' of those who responded had concerns about aspects of their referral management scheme.

Dr Nigel Watson, chief executive of Wessex LMCs, said a referral management centre in Dorset was e-mailing GPs demanding to know within 24 hours whether they had offered the option of an independent sector treatment centre.

Calderdale PCT in West Yorkshire has refused to add ENT and neurology referrals to waiting lists and has established a triage/audit group to manage referrals in the interim.

Dr Alan Brook, a GP in Brighouse, said: 'A lot of these recent developments have occurred without any consultation at all, which has angered local GPs.'

GPs in Cornwall have also complained that PCTs are regularly intervening with referrals in order to manage waiting lists.

Dr Andy Stewart, a cabinet member at Cornwall and the Isles of Scilly LMC, said: 'If we have our referral interrupted, the responsibility until referral gets to secondary care is still ours.

'It could put us in professional jeopardy if some of those referrals go missing.'

In areas where GPs and consultants had been involved in setting up the referral management centre, the process has been better received and there had been fewer problems, the BMA said.

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