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'Look for root cause in somatic disease'

The Department of Health has criticised GPs for referring too many patients for hip replacements.

In its response to an earlier report from the parliamentary committee of public accounts, the department called for 'robust exchange of information between GPs and trusts to develop appropriate referral patterns'.

But GPs claimed Government targets unfairly assumed that every referral not ending in surgery was inappropriate.

Dr Iain Gilchrist, a member of the steering committee of the Primary Care Rheumatology Society and a GP in Bishops Stortford, Essex, said: 'Some people feel orthopaedic surgeons are employed to operate and that therefore anyone who isn't operated on is a wasted referral.'

He said he received no feedback on his own referrals and 'hadn't a clue' whether they were appropriate.

The department has called for PCTs to feed back information 'to ensure lessons are learned' and claimed its forthcoming musculoskeletal strategy would address the issue.

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