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Independents' Day

Hunt cracks down on hospitals ‘pointlessly’ re-referring back to GPs

Health secretary Jeremy Hunt is set to put an end to hospitals asking GPs to re-refer patients who have missed an appointment, as part of a  range of measures designed to free GPs from needless bureaucracy.

The Department of Health said all CCGs will be told to ensure hospital rearrange appointments with patients themselves as part of a drive to free up two hours of GP work a week.

Mr Hunt will announce later today that the Government is also planning to introduce a single payment system for GPs to replace the current fragmented system, which together he claims will lead to a ’5% increase in workforce capacity equivalent to 15 million appointments a year’.

The DH said it ‘had listened to GPs’ and comes after GPC chair Dr Chaand Nagpaul sent a template letter only last week for practices to send to CCGs to demand the end of time-wasting re-referral policies.

It comes after the NHS Alliance and Primary Care Foundation report Making Time in General Practice, released earlier this month, estimated that 15 million appointments could be made available by cutting bureaucracy around rearranging hospital appointments and chasing test results.

Dr Nagpaul told Pulse that the waste of appointments was ‘completely scandalous’, and welcomed the DH’s support in ‘reinforcing’ the message.

The measures will be announced by Mr Hunt in a speech on increasing patient power in the NHS, which the DH said will include:

  • ’Immediately stopping pointless referrals from hospitals back to GPs – a waste of time which accounts for around 2.5% of appointments’;
  • ’Introducing a single payment system that covers all transactions to stop GP practices chasing different organisations for payment’;
  • ‘Making surgeries paperless by 2018 and ending the use of fax machine communications between hospitals and surgeries will also save valuable; resources which can be given over to patient care’;
  • ’Introducing an Ofsted-style ratings system by CCG area covering cancer, dementia, diabetes, mental health, learning disabilities and maternity’.

Mr Hunt will say: ’We’ve made progress in creating a stronger partnership between doctor and patient, but we still put too many obstacles in the way of doctors and nurses wanting to do the right thing. 

’By being more transparent than ever before about crucial services and freeing up more time for GPs to care, we really can make NHS patients the most powerful in the world.’

Reacting to the proposal to curb re-referrals, Dr Nagpaul said: ’We think it is crucial that this happens. However it is not just missed appointments, it is a raft of bureaucratic workload shift from other sectors: chasing up results, expediting follow-up appointments, patients coming to see us when they have had a hospital appointment but they have queries about their treatment.

’They are always being told to see their GP and it is just blocking up our appointments.’

However, he said the proposal to give CCGs ‘Ofsted-style’ ratings on different clinical areas was ‘crude’ and ‘not meaningful’.

The Government has promised to reduce GP bureaucracy, with one previous measure including the reduction of QOF by 40% in the 2014/15 GP contract.

The RCGP has also called for an immediate halt to CQC inspections, while leading general practice expert Professor Martin Roland has called for a dramatic reduction in CQC inspections.

Reaction: DH crackdown on unnecessary workload dump on practices

Readers' comments (33)

  • has Agent Hunt gone on half term holiday and left his assistant to write his speeches? Or could it just be a case of the 'infinite monkeys' that has generated a vaguely sensible suggestion from him? Perhaps if we leave him alone with his typewriter for long enough he will come up with a really good idea and sack himself

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  • Vinci Ho

    The 'perfect' villain is not 'always' bad, mate.What is being proposed is rather straight forward and more importantly , involves no change in funding/money. Devil in small prints: the Ofsted style is the real McCoy as QOF is leaving us(QOF is the legacy of Labour regime anyway).
    Some people may say,' don't be so negative . He has listened.'
    OK.Let's see what will actually happen :changing people's mind in staying or joining general practice ? The truth is always out there........

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  • A welcome change, however you can guarantee hospitals will find a way to bypass it, just like they do the RTT rules by claiming people are 'ill' and so clock stops.

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  • That sounds very sensible!!! The cynic in me says there will be a caveat in there or the CCGs won't listen.

    And as for cutting bureaucracy by 40% in QoF - that is not true - there has been a slight reduction but the recycled money means there are other targets to get

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  • I don't believe it

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  • The reason why hospitals were bouncing back to GPs is because PCTs and now CCGs were no longer paying for consultant to consultant appointments and amid concerns for patients passed round and round the system and no record of how long they are waiting and the status of their treatment.

    Presumably under this new policy CCGs will not be expected to pay for any internal referrals since the GP will have no influence once the first referral goes in. In addition one presumes that the hospitals will be expected at their own expense to start recording the waiting times officially of internal referrals?

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  • Dear NHS Manager,

    You have been spot on.

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  • We need to get rid of the " infernal market " system . That would be sensible .

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  • Call me paranoid - but surely this is just a reannouncement of the award of the PCS contract to Capita? He'll claim this as the installations of a single national system, together with the use of SBS for payment processing.

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  • Restoring or ’Introducing a single payment system that covers all transactions to stop GP practices chasing different organisations for payment’sounds fine: is the implication that all authorisation for payments will also come from a single source?
    Or does it mean that the intention is to pay all surgeries on a single entitlement system and abolish not only QOF but also Enhanced Services and other differential payments to differnt practices?
    Hospitals are still refusing to issue sick notes: does anyone think Jeremy Hunt has the power to enforce anything he says in a speech - at any rate on hospitals?
    Just curious..

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