GPs threatened with ‘sanctions’ as referrals pressure mounts

By Ian Quinn

GPs have been threatened with ‘sanctions' if they do not stop referring patients to hospital and direct them to new community-based services instead.

NHS Harrow has set out plans to ‘take a more assertive performance management role with GPs', with penalties for those who do not alter their referral patterns.

The trust is launching community-based services for paediatrics, ENT, urology and diabetes, and has already shifted dermatology, gastroenterology and orthopaedics services out of hospital.

‘While the services are well received and have reduced hospital referrals, there have been issues with compliance. We are moving to a much clearer position where GPs are incentivised to use the service with sanctions for those that do not,' says the trust's 2010/11 operating plan.

GPs in the area are fighting strongly to maintain the right to refer patients to hospitals if appropriate.

GPC negotiator Dr Chaand Nagpaul, a GP in Stanmore within NHS Harrow, said: ‘This is an important right that is being asserted by local GPs. It would be quite wrong for trusts to enforce sanctions.'

But NHS Harrow said: ‘GPs would be at risk of not making the most of PBC incentives if they didn't use the referral management scheme. We'd also have to question why they're not making best use of NHS funds.'

Elsewhere, PCTs are ramping up plans to shift services out of hospital. NHS South East Essex plans to transfer 48% of hospital outpatient activity to the community by 2014. NHS Liverpool plans to reduce GP referrals by 20% in dermatology, 20% in gynaecology and 10% in gastroenterology.