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GPs go forth

CCG instates minimum 12-week referral waiting times

GPs in one area will have to tell patients they need to wait at least 12 weeks for non-urgent treatment in secondary care going forward.

NHS Cambridgeshire and Peterborough CCG is currently bringing in minimum referral waiting times to help plug deficits.

The area is one of 14 struggling health economies singled out for the Capped Expenditure Process (CEP) - a regulatory intervention brought in by NHS England and NHS Improvement to cut spending in places with the largest budget deficits.

Th minimum waiting time will apply for all adults requiring non-urgent treatment, whilst children will be exempt from the rationing procedure.

The CCG stressed that patients would still be seen within the 18-week target set out in the NHS Constitution.

Jonathan Dunk, the acting chief officer at Cambridgeshire and Peterborough CCG, said: 'As part of cost management for the local health system we are proposing that 12-18 weeks would be the expected waiting time for adult non-urgent cases.'

He added that 'any urgent treatments such as emergency life, limb, sight or hearing treatment, or cancer diagnoses and treatment' would not be subject to the minimum waiting time.

The CCG, which agreed the policy at a meeting with NHS England and NHS Improvement in May, has already decided that it will freeze access to free fertility treatment, unless there are exceptional circumstances, in a bid to save costs.

Other rationing measures agreed at the meeting included replacing direct oral anticoagulants (DOACs) with warfarin; encouraging GPs and hospital doctors to reduce out-patient appointments 'where this is of low clinical value'; as well as introducing over-the-counter prescribing restrictions.

According to board papers, proposals that were not agreed at the meeting had also included restrictions on patient choice 'in order to repatriate work from the independent sector'; and delaying the implementation of NICE recommendations on the use of new and existing medicines and treatments.

Mr Dunk said that the CEP had given the CCG the 'opportunity' and 'support' it needed to 'discuss the measures required' to agree an 'affordable' plan for 2017/18.

He said: 'The proposed measures resulting from this process will enable our health economy to achieve the best possible clinical outcomes for the public we serve, whilst ensuring expenditure remains within funding levels available to the NHS in our area.'

Under the CEP, which was launched in April this year, 14 struggling health economies were presented with a cap on spending and a range of savings ideas.

In the case of Cambridgeshire and Peterborough, the area's plan was £9.7m above the financial control total for the area, made up of CCG and NHS trust budgets and the area's sustainability and transformation fund allocation.

Readers' comments (9)

  • National Hopeless Service

    Great bit of commissioning. The patients will continue to plaque the GP for help with their problems but GP contacts are of course 'free'.

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  • Free and limitless

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  • The DOAC part is terrifying. The burden on primary care would be enormous in our ccg after 18-24 months of being 'permitted' to prescribe when appropriate in place of warfarin.

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  • I can't see DOACs are any cheaper when staff costs of warfarin monitoring are taken into account, let alone the morbidity from subtherapeutic INRs.
    Or is GP time free again?

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  • What's a DOAC?
    we have NOACs, but never heard of a DOAC.

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  • Appalling.

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  • Financial control is the only target that can't be missed. Patient suffering, experience or quality of care can all be ignored so long as the randomly allocated control totals are met! The Internal market is such a flawed idea it should either be scrapped or opened to all comers. NHS fighting NHS for use of the public pound is so wasteful as there is no winners only losers. Particularly patients who are pawned around a system that treats them as cost burdens!

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  • why will that help in the long term? just pushing the budget/appointment availability 12 weeks down the line?

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  • 12 weeks is still pretty quick

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