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GPs in controversial scheme given smaller incentives to cut referrals

By Lilian Anekwe

GPs at the centre of a row over incentives to reduce referrals are defying GPC guidance and pushing ahead with a new version of their scheme.

But Oxfordshire PCT has agreed a new system with GPs that waters down the most controversial element by ‘dramatically' reducing payments for hitting specific referral targets.

The lucrative incentives for reducing referrals offered by the Oxfordshire scheme made it one of the most controversial in the country – and in the trust's eyes a success, after it cut rates of GP referrals by 30%.

But GPC guidance issued earlier this month urged GPs not to sign up to ‘clinically inappropriate' schemes offering ‘perverse incentives'.

Dr Stephen Richards, chair of Oxfordshire PCT's clinical executive committee and a GP in Woodcote, Oxfordshire, said the rewards had been cut in response to the professional and public backlash: ‘We will definitely be renewing the demand management component but the reward for reaching a set target will be dramatically less.'

Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxfordshire LMC, defended the right of local GPs to sign up to the scheme: ‘I have confidence the vast majority would not put their own gain before patient need.'

But health think tank the King's Fund attacked referral incentive schemes last week. In an editorial published in the International Journal of Integrated Care, Dr Nick Goodwin, senior fellow in health policy at the King's Fund, claimed they ‘almost certainly put some patients at risk'.

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