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Independents' Day

GPs face complete halt on all non-urgent referrals under CCG plans to cut costs

A north-west CCG is proposing to completely suspend all non-urgent GP referrals to local hospitals for up to fourth months in a drastic bid to balance its books.

The move by NHS St Helens CCG could see GPs blocked from referring any patients for non-urgent treatment over a winter period for a ‘maximum’ of four months, so that hospitals can concentrate on urgent referrals such as for suspected cancer and sick children.

It did not detail how it would block referrals, but said that any decision to not refer will be made in agreement by the patient and the GP.

The CCG – recently rated ‘inadequate’ by NHS England – admits the move 'will not be popular', but adds it is facing a £12.5m funding gap over the next year after a £3m overspend. 

It has put together a two-year recovery plan to achieve the £12.5m savings this year and a further £17.5m next year - as well as the necessary 1% yearly budget surplus to meet the statutory duty to achieve financial balance.

As part of this, it has launched a consultation on a raft of measures – including the plan to pause referrals into the local hospitals – to ‘suspend, reduce or withdraw certain services’ in order to help close the funding gap.

In a press statement, the CCG said: ‘One proposal is to pause (temporarily suspend) non-urgent referrals to hospital for a maximum four month period. Hospital referrals are one of our biggest area of financial pressure and currently activity in the hospital exceeds the budget we receive.’

It added that ‘any decision not to refer will be made in agreement by the patient and GP’.

The four-month pause of all non-urgent treatment over the winter months would ‘support hospitals during the busy winter period’ and enable them to ‘concentrate on treating patients who require urgent referrals, suspected cancer and referrals for sick children’, commissioners said.

And the move will also ‘reduce the risk of your operation being cancelled during the busy winter months when there are less non-urgent beds available’.

CCG lay chair Mr Geoffrey Appleton commented: ‘Although we are trying to make as many efficiency savings as we can (buying the same or similar services for less and reducing waste), our funding gap is so large we know these measures alone will not bring a resolution and we are faced with the prospect of proposing to suspend, reduce or withdraw certain services.

‘We recognise these proposals will not be popular but we will be involving those, who want to have their say, in the discussions and we welcome your thoughts about how we should be making cost savings.’

The public is being invited to comment on the proposals through an online survey and the consultation lasts until 5 October.


Readers' comments (71)

  • And Jeremy is still talking about routine 7 days GP access????

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  • This doesnt quite follow GMC guidance - so best of luck

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  • No referrals, apart from two week cancer waits and urgents, for four months. It sounds like a medical prosecution lawyer's paradise. The train has now really hit the buffers!

    I wouldn't be surprised if other CCGs adopt similar policies. God help GPs and patients.

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  • GMC will be busy. Patients will be well annoyed. Point them in direction of their local MP.
    very dangerous for patients and GP

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  • Maybe time to address the patients directly and say they're up the creek without the proverbial paddle and if they don't make some really hard decisions, there will be no service at all??? I think we've created patients who feel they have a right to healthcare services whenever and wherever they want (regardless of urgency/emergency/routine) It's a real shame that this CCG has decided to take this action.

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  • Has this been discussed with GMC BMA and MDU?
    Thank goodness I resigned

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  • I can't see any need for this. If I refer a patient routinely they get seen within a few weeks in my area. In fact I can get ultrasounds and mr scans done within a few days to help determine whether referral is needed at all. Oh wait. Sorry. Just realised I'm in Perth Australia!

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  • Simple two step process for local practices:
    1) Refer anyway - let the risk sit with the CCG not you.
    2) Set up a private practice and refer them that way.

    The thing with GP-land is everyone wants to make a saving by dumping the cost and risk at your door.

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  • Elephant in the room time. Lets face it, many referrals are initiated by a$$-coveritis and ignoritis. Train better GPs via better selection criteria and longer VTS training and ta daaaa problem solved. Oh, and educate patients and stop free prescriptions and get rid of all politicians and genetically correct human nature. Easy really.

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  • Peter Swinyard

    I hope all the GPs on that CCG's board have resigned over this? Otherwise, if they are held to be blocking referrals and a patient comes to harm, Sue, Grabbitt and Runn will be after them personally as well as the doctor who did not refer. I wouldn't "agree with patient not to refer" - we don't refer for fun, nor to CMA for the most part, We refer either for treatment which we are not able to provide in general practice, or for investigations we cannot provide or for opinion. We really need to move thought from this impoverished level to more imaginative ways to work within a budget - or to make it quite clear that the budget is inadequate and have nothing to do with this type of bribery-rationing.

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