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Independents' Day

CCG backs down on plan to block all non-urgent GP referrals

CCG leaders have backed down on plans to suspend all referrals for non-urgent treatment after GP leaders said the proposal was ‘unacceptable’.

Pulse revealed that NHS St Helens CCG had floated the idea of pausing non-urgent referrals to local hospitals over the winter, as part of a range of cost-cutting measures to help balance its books.

But the CCG said it had decided to withdraw the option ‘in light of feedback to date’.

The GPC said it was pleased the CCG had listened to objections to the proposal, after warning it would lead to missed diagnoses of serious illness – and cost the health system more in the long-run.

In a press release the CCG said that ‘it is clear that one of the options, pausing non-urgent referrals, is not supported’.

The statement continued: ‘For this reason, we are withdrawing this option.’

The CCG’s consultation on other measures – including cutting back on prescriptions of over-the-counter medicines and gluten-free foods, as well as limiting access to IVF – will continue as planned until October.

NHS St Helens CCG lay chair Mr Geoffrey Appleton said: ‘Since the consultation began we have been listening to and considering all the feedback we have received regarding our proposals. As a result of this we have taken the decision to withdraw it from the consultation.

‘The financial challenges NHS St Helens CCG faces have not gone away and we will now be looking at other measures we can introduce to assist with the £12.5 million funding gap.

‘We will continue to work with our partners in the local health system to identify other opportunities where savings can be made. This will undoubtedly still involve some tough decisions about what is affordable but we will continue to consult with local people on our new proposals and listen to their views.’

Deputy chair Dr Richard Vautrey said: ‘We're pleased to see St Helens CCG has listened to concerns from the BMA and others and made the right decision.

‘This does not address the underlying problem, that investment in the NHS is not keeping up with demand.’

St Helens CCG is one of 26 CCGs recently rated 'inadequate' by NHS England.

The CCG is faced with finding £12.5m savings this year and a further £17.5m next year - as well as a standard 1% yearly budget surplus - in order to meet its statutory duty to achieve financial balance.


Readers' comments (15)

  • Whew:)

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  • Bet that LES's and many other payments to GPs will drop

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  • Vinci Ho

    There is a tale we tell in Hong Kong:
    In ancient time, burglars usually tried to gain access to a house through a small hole in the wall of the back garden in night time . The worst thing that would happen is getting his head smashed by the guard on the other side of the wall . So to 'test the temperature of the water' , this thief pushed a porcelain hot pot through the hole first to ascertain safety.(賊佬試沙煲)

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  • Looks like some pretty basic PR.

    Well done for backing down on banning all referrals.
    While that happened nobody cared enough to object to your other options.

    I do have sympathy with CCGs - but i think some honest about the budgets are needed, not smoke and daggers.

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  • But that CCG has GPs on its board, what on earth were they thinking of letting that proposal ever see the light of day in the first place? Why didn't they shoot it to shreds when it was first mentioned in their meetings?

    You do have to wonder what is fundamentally and extremely seriously wrong with the GPs on CCG boards. Since no sane, uncorrupted GP would ever let this idea get passed them, please explain how this idea got passed the GPs on that CCG board? They must have endorsed it. How can they be so out of touch with reality? And if so, how come they haven't been removed?

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  • Russell Thorpe

    This CCG is reminiscent of Col Nicholson from Bridge over the river Kwai striding into the hospital to find men "fit to work" This nonsense only saw the light of day because it was fellow GP's who came up with it.
    It wouldnt even work as all you would do is create a huge backlog of work to pay for at a later date.

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  • Irrespective of this event it reveals the problem of adequate funding in a locality. However despite that, it is irrelevant because the black hole of acute trusts will steal any appropriate funding in general practice.

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  • Sirs/Md.
    I am totally puzzled by the attitudes of many GPs and also Mr. Vautery, regarding their lack of knowledge about the GMS regulations. No body, CCG or otherwise, can legally block any referral or prescription written by any GP. The only way, illegally, would be to impose a physical block ie., to stop referral letters reaching the hospital referral receiving agency. This can be circumvented by GPs by hand delivery to the appropriate dept. The CCG can legally instruct a hospital not to receive any referral letter. This can be partially circumvented by sending referral letters by registered post where receipt may be refused. All that GPs are required to do is to send letters and be sure they are received. A signed letter from the CCG telling GPs not to refer ( not "suggested "by the CCG), or a postal receipt from the post office saying "refused delivery" is enough to protect a GP. In my practice all referral letters were followed up by my receptionists and practice manager, to ensure they had been received by the appropriate hospital, and records marked with date and time. One of the causes of complaints and grounds for breach of contract is. "failure to refer". If letter blocked by any body, then GPs must proceed to treat themselves , in conjunction with the defence Union. If even semi urgent, the same referral can be converted to urgent, explaining the circumstances to the consultant. Our leaders, especially the BMA are actually useless. What was done about the 2004 first imposed contract by Kenneth Clarke. I now hear the MPIG has been withdrawn. Any reaction? Of course, the BMA represents us GPs and we get the government we deserve.
    Retired GP.

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  • So are the CCG members who dreamed this up resigning? They should be - either on the grounds of misjudgement or on the grounds of being in an impossible position.

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  • Pulse - I've respected your journalism for many years but don't you think you are becoming a bit sensational? CCG floating the idea and seeking GP opinion and abandoning the idea as a result is hardly "backing down". In fact, it looks like a good governance process to me. Your misleading article is making GPs dissociate from being involved in commissioning as you can see from the posts above.

    p.s. I have no connection with St Helen's or it's CCG what so ever.

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