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GPs go forth

‘Our profit-sharing incentive will reduce delays’

The profit-sharing incentive scheme at NHS Coastal West Sussex CCG will reduce delays by cutting inappropriate and incomplete referrals, argues board member Dr Jeremy Mayhew

We know that historically people have been referred without the right information or have been directed to a service that isn’t right for the treatment they need.

Last year the CCG made a really positive agreement with the GP practices to support them to work together to make sure that all of the referrals that are made in Coastal West Sussex go to the right service with the right information when a person needs a particular treatment or type of support.

It is important to be clear, any patient who needs a referral absolutely will be referred for the treatment and support they need – and there is no restriction on the number of referrals a GP practice can make.

The agreement focuses on reducing the number of inappropriate or incomplete referrals, when a patient can be waiting several months only to be bounced back to their GP practice – causing a delay in care for that patient and a cost to the NHS system.

It encourages GP practices to improve the quality of their prescribing and referrals – so to make sure regular reviews of a person’s medicines are taking place and people are on the right medication, and that referrals go to the right service with the right information when a person needs a particular treatment or type of support.

In turn this would help to reduce or explain where there can be wide variation in referral rates between GP practices and doctors within those practices.

GP practices, working together in practice groups, look at their referrals to specialists to make sure that all of those referrals are necessary and appropriate. They are also able to share learning, consider the latest national guidance, and make sure they are aware of local service developments (i.e. new services or clinics in the community where local people could be seen).

GP practices and the CCG are very clear that if a patient needs a referral then that referral should and will be made – but inappropriate referrals should be reviewed and reduced as these could potentially mean the delay of treatment to others.

This is right for patients to make sure they are being referred to the right place first time, and not being delayed by people who are being referred when they are not ready for that service, or need an alternative treatment.

Inappropriate referrals, even those that bounce back to the GP practice without a patient receiving any further treatment or support, cost the NHS money. 

To encourage GP practices to take the time to review their referrals and share this learning, money saved within the system is being reinvested in improving patient care.

After approval by the CCG, funding is available for schemes led by practice groups to improve access to primary care services and the development of local community services; no GPs receive payment, directly or indirectly.

To date this scheme has helped to fund extra appointments over winter, new clinics for minor injuries, and to place clinical pharmacists in GP practices to help with medicine reviews and treat patients directly.

We want to reassure everyone that this scheme has been put in place to improve care for local people, and to make it easier and quicker to get the care you really need when you need it.

Dr Jeremy Mayhew is clinical lead for primary care at NHS Coastal West Sussex CCG



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Readers' comments (5)

  • Thanks. Have you ever read the NICE guidance on cancer referrals, you know, the one we’re all judged on in courts and things.
    perhaps may be worth a look?

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  • Lol I think Dr Mayhew protest too much!

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  • AlanAlmond

    Defending a basically corrupt idea - financial incentive to reduce the number of referrals made. Fudge it around and try and explain it all away with subtle nuance? I’m sorry but you got lost somewhere Dr Mayhew. I suggest you stop digging.

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  • Surely better ways to spend your time, also to whom are referrals ‘inappropriate ‘ ?

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  • Taking an increased profit for not referring patients? Well at least it's more descriptive than calling it "savings" but not a well-chosen word to appease patients and media

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