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GPs told to refer patients to private sector in bid to cut local trust’s waiting times

Exclusive GPs in Hertfordshire have been told to refer patients to private hospitals in a bid to control soaring waiting times at the local NHS trust, Pulse has learned.

NHS Herts Valley CCG has told GPs to refrain from referring patients to West Hertfordshire NHS Trust (WHHT) for non-urgent appointments wherever possible, and has particularly encouraged GPs to not refer for certain specialties, including cardiology, ENT, urology, pain, and general surgery.

Instead GPs have been told to refer patients to alternative hospitals, including local private providers, while the Trust is in the process transferring existing referrals to the private hospitals. The referrals will be funded by the NHS.

This is in a bid to cut waiting times at the trust, which has failed to meet national 18-week referral to treatment targets.

It follows the proposal by NHS St Helens CCG to defer all non-urgent referrals over a four-month period this winter - from which it later backtracked. 

NHS Herts Valley CCG has asked GPs ‘wherever possible to refer to alternative NHS and independent sector providers’ in a letter sent earlier this month headed ‘urgent for action’

In addition they have been told not to refer any patients at all to eight specific specialties ‘for the next three months in the first instance’.

The letter explains that WHHT is failing to meet the 18-week referral to treatment standard ‘in a number of specialties’ and that the hospital is ‘performing at a rate of 89% against a target of 92%’.

The eight specialties that are particularly hard-pressed include cardiology, ENT, urology, pain, general surgery, ophthalmology, trauma and orthopaedics and rheumatology.

In addition, the letter says that WHHT is ‘seeking additional capacity from the independent sector and transferring patients for treatment’.

The CCG adds that it is also reviewing referral thresholds ‘as we need to ensure these remain within the overall funds available to the CCG’.

NHS Herts Valley CCG told Pulse in a statement: ‘Currently WHHT is experiencing some pressures on its ability to deliver the required waiting time of 18 weeks from referral to treatment in a number of specialities.

‘We have advised GPs that they can suggest alternative non-urgent referrals to their patients away from WHHT for a short period of time (initially three months) to allow the trust to clear the backlog of patients waiting.'

Pulse reported last week that NHS St Helens CCG proposed to suspend all non-urgent GP referrals for four months over the winter in a bid to tackle a £12.5 million funding gap for the year.

It later backed down, after GPs has said the move was ‘unacceptable’ and warned it would lead to missed diagnoses and cost the health system more in the long run.

Another cost-cutting scheme in Devon saw GPs having to carry out management plans and treatment for one-third of all patients they had referred to urology specialists.

Last year, NHS Redditch and Bromsgrove CCG asked GPs to not refer to a local acute trust for at least three months to allow the hospital to clear up its backlog of operations.

Note: this article was amended at 18:15 at 19 August 2016 to reflect there has not been a bar on any referrals but GPs are being encouraged not to refer for certain specialties

Readers' comments (11)

  • All in all it was all just bricks in The Wall

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  • Q.Do we want our referred patients to be treated in a safe,timely and effective way?
    Q.Given that private providers meeting the above criteria can only charge the same tariff as NHS Trusts, is our duty of care to our patients or to a political shibboleth ?

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  • In addition ... not to refer any patients at all to eight specific specialties ‘for the next three months in the first instance’.

    The eight specialties with a complete bar ..... and rheumatology.

    So what of Standards re referral time??

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  • I trust they won't complain when NHS IC and HD units have an influx of patients then?

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  • Every doctor can and should refer EVERYONE who they feel it is necessary needs a specialist opinion. It is the job of the CCG/NHSE/someone else to sort out. DO NOT LISTEN TO THIS ADVICE NOT TO REFER. The GMC/NHSE/CCG will not give you any support if you do not refer or delay the referral. Not your problem at all.

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  • Not to refer if appropriate would be unethical.

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  • NHS Herts Valley CCG is treating its targets not its patients

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  • Hasn't it always been the cynical view that an NHS consultant must somehow maintain a waiting list .. to ensure their personal private practice

    Has anyone investigated why there is such a backlog
    And what is being done about it

    Agree GP's have to do what is Medicolegally safest for the patient

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  • they are not saying not to refer they are asking us to use private providers. I just think that it is poor that we are underinvesting in our existing health system and that we then have to use these outside agencies. Why are the hospitals not expanding to take on new staff? Where is the support for development of GP special interest?

    -anonymous salaried!

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  • well at least their ccg has the money to afford to do this.

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