GP referrals clampdown ‘in breach’ of competition rules

By Ian Quinn

GP referral clampdowns look set to be outlawed under the Government's competition rules, with an inquiry by the Cooperation and Competition Panel finding they fly in the face of patient choice.

An interim report by the CCP released this morning said it had uncovered ‘patterns of behaviour' that it believed were inconsistent with the NHS Constitution and it revealed 70 PCTs were being investigated for alleged breaches of competition rules.

The report looks set to be a bombshell for trusts pinning their financial plans around schemes to slash hospital activity and comes a day after an investigation by Pulse revealed a huge expansion of GP referral management, with one in eight GP referrals rejected.

The CCP identified a series of restrictions introduced on GP referrals which it believes are against competition rules, including:

• Referral management centres which direct patients to particular providers rather than offering patients a choice of provider
• Provisions in contracts with providers that restrict patient choice including activity caps and reductions in the types of procedures that providers can offer
• The imposition of mimimum waiting times before providers can treat patients

CCP director, Andrew Taylor, said: ‘At this stage of our review, the evidence suggests that there is a significant amount of activity in the system which appears to be inconsistent with the Principles and Rules.'

CCP chair, Lord Carter of Coles, added: ‘Our interim report highlights that some parts of the NHS has yet to fully embrace the role of choice and competition. Both NHS and independent sector providers are being hampered in their efforts to deliver the kind of choice that is expected by patients.'

Pulse's investigation this week revealed four in five PCOs have now introduced referral gateways, with GPs in NHS South West Essex facing restrictions on 213 different procedures.

With 13 million people consulting their GP with a skin problem each year, dermatology care will be under close scrutiny as practices strive to reduce referrals. Attend this Pulse one-day Dermatology seminar in May to update your knowledge of skin conditions