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Little confidence in GMC's abilities

GPs should be banned from referring patients with anxiety or depression to community mental health teams, an NHS report recommends.

The Health Technology Assessment, which will be circulated to all PCTs, found allowing GPs to refer was twice as costly as insisting they managed the patients themselves.

'Health care providers could consider adopting policies of restricting referrals of unselected patients,' it recommended.

GPs reacted with consternation to the proposals, arguing they were already struggling to cope with burgeoning workloads and limited resources.

The assessment found patients with common mental health disorders received similar levels of care from GPs and community mental health nurses. But while GP care cost an average of £316 per patient over six months, care from community mental health teams cost £631.

Dr Laurence Mynors-Wallis, one of the assessors, said: 'There is no point in referring patients with common mental health problems. The nurses are unable to do anything that cannot be done in primary care.'

Dr Mynors-Wallis, medical director of Dorset Healthcare NHS Trust, added: 'Community mental health teams are a scarce resource. They are highly skilled nurses and should be reserved for patients with severe mental illnesses.'

He suggested GPs could cope with the extra patients by referring them to primary care staff who would provide counselling and CBT.

But GPs and mental health experts said psychological therapies were in short supply.

Dr John Dracass, a GP in west Hampshire, said: 'It's easy for academics to think up these jolly good ideas based on resources that are not actually available. We are desperate for access to counsellors and CBTs as it is in this area.

'As for cutting costs, if you don't allow GPs to refer to community mental health nurses, they will simply refer to consultants which will be even more expensive.'

Dr Chris Manning, chief executive of Primary Care Mental Health and Education, said: 'GPs are reluctant to prescribe and there are already limited options for referring mental health patients. It is an absolute mess.'

By Emily Wright

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