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CCGs successful in reducing GP referrals, says NHS England

GP referral rates to hospitals for elective care have fallen by nearly 2% in the last year, NHS England has said.

The latest board papers reveal that elective GP referrals have fallen by 1.6% between 2016/17 and 2017/18, compared to an average annual growth of 3.8% in the previous four years.

The paper, which looks at NHS England’s progress on implementation of the NHS Five Year Forward View, praises CCGs for curbing demand on hospitals.

The papers said: ‘CCGs have had considerable success over the past year in moderating the growth rate of hospital demand.

‘For elective care, GP referrals actually fell by -1.6% in 2017/18 (compared to average annual growth of 3.8% in the prior 4 years).’ 

This comes after a Pulse investigation revealed that nearly a quarter of CCGs implemented a cash incentive scheme to cut GP referrals.

RCGP chair Professor Helen Stokes-Lampard said such schemes were ‘insulting’ to GPs, adding that GPs are ‘highly-trained medical professionals, who know our patients, and will act in the best interests of their health and wellbeing’.

Last year, NHS England tasked CCGs with achieving a ‘slower growth in referrals’, saying rising demand for elective services was ‘leading to an increasing national waiting list [and] longer waiting times’.

It comes as the overall number of GP referrals, also including urgent referrals, dropped for the first time in six years in 2017, when the number fell by 2% compared with the year before.

An NHS England spokesperson said: 'NHS England is working with local health bodies and GPs to find alternatives to hospital referrals where it is appropriate and right for the patient.'

Readers' comments (6)

  • AlanAlmond

    The longer term consequences of this are unknown. There will most certainly be people who will die for lack of referral. Naturally these negative outcomes will be sufficiently removed in time and place from the architects of this misguided policy, for the people responsible to allow themselves to believe all they did was save hospitals some money. Ignorance of the evil you do does not make your evil less malign. I hope there is a god.

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  • Vinci Ho

    One has to understand that NHSE has a ‘duty to spin’ and find some merits from what the government/DHSC had done so far on NHS . The reality is condemning reports(including those from National Audit Office) about outcomes in hospitals and primary care are everywhere .
    Too bad the opposition leader is not a potent pressor/orator though he keeps choosing NHS as a battleground against the PM during Prime Minister Question Time. But that does not discard the embarasssing fact that there is a diminishing credibility and reputation of NHSE and Mr Stevens day by day . The latter might appear to be the ‘acting’ Health Secretary where the real McCoy is perhaps more ambious to become the next prime minister(his extraordinary readiness and lower threshold to apologise to the public could be a glimse of evidence).
    The ‘success’ of 5 year GP forward view , so far , has clearly contradicted the word ‘forward’ . At least , it is evident in terms of which way the total number of GPs is going .
    This brings back to my old argument; no matter how ‘noble’ a policy pushed forward by NHSE and its leader is , it is doomed to fail simply because it does not have the trust of people.

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  • Fewer emergency referrals means more elective referrals..opposite true?

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  • Short term. If the patient needs to be seen they need to be seen. No GP wants to reduce clinical safety especially with the yard stick we are measured with. NHSE should be realistic and fund a service if they want a good one.

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  • Curtailing referrals will result in claims in the long term and only GPs will suffer. Compalints come months or years after mishaps have occurred only when patients realize that the GP should have referred but he probably took some pennies from the CCG to doom him/her. And the clock for the Court starts ticking from that point, not when the referral should have been made. So, before we lick asses to get a clap on the back from CCGs or NHSE or before we accept the pennies, we need to think - it's about patients' lives first and last.

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  • If you look at CKS website g for any non self limiting condition it will direct you towards referring patients. This being the case , I can’t comprehend how the GP can reduce referral and defend it successfully if challenged.

    Patient safety is paramount and should always come first not saving money

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