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GPs buried under trusts' workload dump

GPs told to refrain from referring to local hospital for three months

GPs have been asked by commissioners to not refer to a local acute trust for at least three months to allow the hospital to clear up its backlog of operations.

The chair of NHS Redditch and Bromsgrove CCG, Dr Jonathan Wells, shared the letter online which asked GPs ‘to refer patients to another NHS or independent sector provider other than Worcestershire Acute Trust for an initial period of three months’.

The letter, which Dr Wells posted on Twitter, explained that the trust’s ability to treat outpatients within the 18-week target ‘has worsened considerably’, with 2,347 patients currently waiting longer than the maximum waiting time for their treatments.

A CCG audit of waiting times found that 66% more people were waiting more than 18 weeks for an operation at the trust compared with 12 months ago and that the situation was particularly bad for ear, nose and throat, trauma and orthopedics, gynaecology, general surgery and dermatology.

Dr Wells said local private hospitals could see patients in all areas aside from dermatology at NHS tariff prices and ‘treat ALL patients within 18 weeks’. But he said GPs could also refer patients to NHS hospitals in nearby Birmingham.

He also recommended GPs use the Choose and Book e-referral system rather than paper or fax, because the tool would allow them to see a list of providers including their current waiting times.

The letter said: ‘Both the CCG and Worcestershire Acute Trust have agreed that we need to create some headroom for a short period of time. We need to allow them to focus on treating the long waiters so that they can move to a sustainable position where they can meet the 18-week standard, and not have an unmanageable backlog of patients waiting over 18 weeks.

‘In order to support the trust in this respect we need to reduce the number of referrals going to Worcestershire Acute Trust, particularly for the specialties mentioned above.’

It added: ‘Whilst I appreciate that active encouragement to divert patients is unusual, I would like to stress that Worcestershire Acute Trust has requested this approach. Without such measures the situation will deteriorate further and our patients will suffer longer waiting times than is acceptable.’

The news comes as NHS South Kent Coast CCG said this week that it was in the process of signing a contract with two hospitals across the border in France to do elective surgery.

The deal, expected to conclude this year, will mean GPs can offer patients treatment in Calais. The CCG said this was due to an open tender to be on the Any Qualified Provider (AQP) list rather than for cost or access reasons.

A recent Pulse investigation also found that GPs around the UK are facing increasing restrictions on referrals in general as CCGs are forced to ration procedures to save money.

Readers' comments (23)

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  • The longer patients suffer the more care they will need.

    Why doesn't the NHSE leave GP's to decide what is really urgent and ban operations like gastric bands boob jobs etc.

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  • And will Dr Wells allow all GP surgeries to stop taking bookings for appts for the next 3 months to allow GPs to catch up? No, I thought not. As usual one rule for hospitals and another for GPs.

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  • surprising advice which is reasonably justifiable -- if there is not a block contract or tarrif cap in place with the hospital concerened.
    If there is such cost contraint arrangemnent in place the CCG has just signed its entry into special measures application for itself and the hospital involved.

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  • It looks like the CCG is trying to be pragmatic. However, is this the real for having E referrals? So that GPs can help distribute workload across acute trusts which are incapable of managing their appointments? More wasted GP time - as if we have it to waste! If we could reach some sort of consistency across acute trusts, patients wouldn't need choice. The NHS is too big and unwieldy and rather than fix secondary care, yet again primary care is expected to shoulder the burden.

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  • Russell Thorpe

    The hospital is effectively saying "Stop the world we want to get off"

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  • surely its just like closing its list for a while. happens all the time

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  • Imagine if we all just stopped for 3 months. Warm glow. Mind you, I'm a year off stopping forever, thank God. Sept 30 2016 has been in the diary for 4 years now. I pity those I leave behind.

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  • The hospital shouldn't worry, half the GPs are taking early retirement and the other half will go of with stress. And as we all know GPs don't do anything other than send patients needlessly to hospital so when they are all gone the NHS problems will be all solved!

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  • @6;29pm
    Do not worry.we will follow you!!!

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  • @6:29

    I left the UK 3 Years ago when i saw the writing on the wall.

    there's no need for pity, todays younger generation have more options than ever if they open their eyes and minds....

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  • This is an embarrassing shambles;

    what happens when the other services you overload become unable to cope????

    THE NHS IS A BROKEN OLD BANGER

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  • As Chomsky said on how to 'cause' privatisation. Starve public services of funds, run down services, make people think it is the public services' fault, and so justify transferring to the private sector. This is evident from the article which even says that private hospitals have capacity- clearly what all this is about;.

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  • the nhs has collapsed there..without any equivocation..collapsed...totally unacceptable disgrace.
    quite ludicrous..deferring referrals for 3 months merely kicks the can down the road until a far worse disaster later when a head of steam of justifiably disgruntled patients erupts into a tsunami...the gp's should simply refer as usual and this failed trust needs to go into special measures and the board sacked.
    and pray tell why should patients be diverted to overloaded birmingham hospitals far away??
    i repeat..the collapse of the nhs has started and is mirrored by the slow motion collapse of primary care.
    This is due to a catastrophically incompetent government and nhse...who mess around with absolute lunacy like personal health budgets pfi the internal market admissions avoidance and endless other utterly incompetent nonsense like the blind maniacs they are..talk about fiddling while rome burns...........i hope they will reap the whirlwind for their blind doctrinaire utterly disgraceful madness.

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  • why cant the hospital forward the referral to a third party provider?

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  • i think we all need to put our legs up and let off some wind... imagine that !! 40000 GPs from all over the country letting off wind at the same time!! that would create enough of a stink to get the government recognize that there IS a problem in GP land!!

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  • It doesnt work - the pressure will just shift til April when theyll get 3 months worth of referrals, extra cost next financial year and unmanageable waiting lists!

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  • If the problems are so acute, why is our unrestrained population growth permitted to continue unchecked? I am heartily pleased to be out of a situation in which the practice of medicine has become so constrained and the delivery of personalised care so difficult.

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  • We should just keep doing our jobs in the best interest of our patients,if the NHS collapses while we are doing this whose fault is it .Not ours.Whereas if a patient comes to some harm cause we have not done the appropiate thing it will be our fault.Do not ask individual GPs to shoulder the risks from a failing health service.The responsibility lies much further up the chain of command (JH).

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  • All the hospitals and all the GPs could say the same thing. Please, do not refer for 3/12.

    Great. How does that work?

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