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NHS cracks down on incentives to curb GPs cancer referrals

Exclusive NHS England has scolded CCGs for offering incentives to GPs for cutting down the number of urgent cancer referrals they make. 

The director of commissioning said that she has been in contact with the CCGs who were giving practices financial incentives to cut urgent cancer referrals to ease pressure on secondary care, as revealed by Pulse last week.

The Pulse investigation found that NHS North-East Lincolnshire CCG and NHS Lambeth CCG were offering financial incentives for practices to cut the number of referrals they made, which included urgent cancer referrals. 

They were among nine overall who Pulse found were setting practices referrals targets in order to receive extra funding.

Following a media outcry, NHS England has contacted the CCGs involved to say that they must ensure that their incentives scheme should not affect cancer referrals.

Dame Barbara Hakin, national director for commissioning operations at NHS England, said: ‘The number of patients referred to hospital for urgent cancer checks is up by over 600,000 over the past five years, and we now want it to go up even more, so as to diagnose suspected cancers earlier.

‘NICE has set out evidence based guidelines for when patients should be referred, and no CCG incentive scheme should in anyway cut across that. We are in touch with each of the CCGs mentioned to ensure that this is very clearly communicated to all practices.’

The GPC said that many of these schemes could be ‘ethically questionable’ and Pulse revealed that the GMC looked into at least one of them to see if it is contrary to the guidance for doctors in Good Medical Practice.

Last week, shadow health secretary Heidi Alexander called for a national review of the CCG schemes.

Readers' comments (9)

  • The sooner we have a salaried service without these perverse incentives the better

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  • Pulse has done a great job on this. Is there any kind of pattern to the type of areas taking the money - eg Lambeth is described aa 'deprived area' presumably there would be more of an outcry if those in an affluent area found out.

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  • The best incentive would be no risk of litigation and being allowed to use our skills freely. Patients are no longer worried about wasting out time and tax payers money. All they care about is the "what if?" scenario. Why see a pharmacist and pay for OTC meds when you can see a highly skilled professional who will also give you free stuff? This sense of entitlement needs to end and it will once it all goes private.

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  • re 6 October 11.39am, the patients would prefer to see a pharmacist than some GP who resents seeing them and wants to see the NHS privatised.

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  • The new NICE guideline aimed to lowered the threshold of conversion of cancer referral to cancer diagnosis from 5% of referred patients (old guideline) to 3%. This obviously means thousands more will be referred, costing may millions more.

    All of the above is perverse when the government is asking for 22 billion "efficiency" savings. I'm not aware of any new money passed to CCG to commission a service to meet the increased demand. I feel sorry for those struggling CCGs who are not given the money it needs yet are still forced to make savings and cater for increased demand which is outside of it's control!

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  • I would have thought that NHSE was pressurizing CCGs to cut down on all referrals and would have know about this. Well, just my way of thinking wrongly, I guess.

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  • Vinci Ho

    Of course , CCGs are scapegoats with GPs on board. We know that from the first day when the Health and Social Care Bill was passed.
    On one hand , cut referrals to save money . Then wants to claim the glory as a government to improve cancer survival. Our indemnity is going up and people are leaving .it is all down to the honesty and integrity of a government with its politicians.

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  • re anon 06 Oct 2015 11:50am

    Your ( meaning leftist cardigan ) mentality is the biggest reason for the mess we are in. You never say no to anything and you massively undervalued our profession. Let me guess, you are close to retirement and you think the world would end if you weren't there for your massively doctor-dependant patients. Do us all a favour and complete your burn out by any means you see fit.

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  • Fair enough to clamp down on inappropriate incentives to reduce medical intervention.

    So when is the NHS going to crack down on inappropriate incentives to increase medical intervention?

    (Statins, tight blood sugar control in the elderly....)

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