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GPs told to delay referrals until April

By Ian Quinn

Exclusive: Thousands of GPs are being told to delay referrals until the next financial year, sparking fears that consortia will be passed crippling ‘legacy debts' in the form of back-logged hospital activity.

The Government bowed to pressure following Pulse's A Clean Slate campaign and spared consortia debt built up by PCTs in this financial year – but anything accumulating from April will be GPs' responsibility.

A Pulse survey of 450 GPs has found as many as one GP in eight has been asked to delay referrals for the final quarter of the year until April, as trusts desperately seek short-term fixes for deficits.

The move has ramped up tensions between NHS managers and GP consortia, who fear they will be hamstrung if they inherit back-logged hospital activity.

NHS West Kent plans to cut nearly £30m by a wide-ranging clampdown on referrals, including deferring all IVF, gender reassignment and bariatric surgery. NHS North Yorkshire and York has told GPs to suspend all referrals for male and female sterilisation services until the end of the financial year.

Dr David Geddes, medical director at the trust, said the move was ‘a temporary measure', adding: ‘We appreciate this will be of concern to clinicians and patients alike, and will evaluate the impact over the coming weeks.'

Cash-strapped NHS Warwickshire is deferring all routine elective hip, knee and shoulder surgery, IVF, bariatric surgery, all referrals for back pain management and all oral surgery and orthodontic procedures.

The trust's PEC chair, Dr Francis Campbell, said the move had been necessary to prevent the trust plunging into multi-million pound deficit: ‘Acute spending was no longer affordable, but waiting times were plummeting. We had to get back into balance and although I understand GPs are worried about debt, I'd argue it would be more likely they'd inherit debts if we hadn't taken these measures.

‘There is a mixture of views among GPs. Some absolutely detest it, but I think there is a grudging acceptance from most that it has to be done.'

But Dr John Derrick, a GP in Rugby, said: ‘When GPs take over and there is debt still lurking, we are going to be piggy in the middle, with patients saying you're in charge and the Government saying you can't have any cash.'

Dr Mahesh Kamdar, a GP in Canvey Island, Essex, said: ‘You will have referrals not going through for two months, so of course this year's budget will be balanced. But come next year and the year after, when GPs take over, there will be a huge backlog.'

Delayed referrals

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