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GPs secure funding for peer review of referrals

15 Nov 2011

GPs have been handed a huge cash boost by their CCG to help them cut their referrals by peer education and support without the need for draconian referral management.

The scheme, set up in Hertfordshire by Herts Valleys clinical commissioning group, has been awarded 202,000 funding from the regional innovation fund to develop support for GPs.

It will involve setting up specialist programmes for each of the top ten specialties - trauma and orthopaedics, dermatology, cardiology, ENT, gynaecology, ophthalmology, urology, gastroenterology, rheumatology and neurology - which together accounted for nearly 60,000 first outpatient attendances across the CCG last year.

Lead GPs in each specialty will lead and provide peer-education via virtual surgeries, web resources and educational events as well as ‘up-skilled' GPs in every large practice.

The CCG - which covers Dacorum, Hertsmere, St Albans & Harpenden, Watford and Three Rivers localities - will encourage smaller practices to federate so that each group of smaller practices has access to an expert GP. All GPs will receive feedback about their referral patterns so continuous learning takes place.

The project will initially establish two lead GPs, followed by another eight. The leads will each receive a budget to fund their on-going development, identification of referral patterns, liaison with leads at locality/practice level, and identification of best practice including care pathways.

It will also fund virtual surgeries running over a six month period so that clinicians can email or telephone with questions about referrals, the development of frequently asked questions and answers logs, and the designing of educational events for clinicians and patients. The project will be evaluated in March.

 

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Dr Jayne Taylor, performance management director at Hertsmere Commissioning Locality, said: ‘CCG referrals resulted in 59,827 first outpatient appointments - at a cost of £9,434,815' in the top ten specialties last year across Herts Valleys.

Dr Taylor added: ‘A reduction of 10% across each specialty would save £943,480 and a reduction of 40% across each specialty would save£3,773,912.'

The scheme would also cut follow-up appointments - which totalled 201,615 in the ten specialties last year - as well as reducing investigations in the acute sector, cutting emergency referrals and reducing days lost from  work and unnecessary travel for patients and their employers as well as efficiencies in GP and practice nurse time, she said.

READERS' COMMENTS

Vinci Ho, GP Partner,
15 Nov 2011
Education , leadership and innovation
Way forward! Keep things in primary care and general practice as much as possible
Secondary care colleagues may not be too happy as this will reduce their activities .....
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Anonymous, Work for health provider,
15 Nov 2011
More lining of their own pockets by fat cat GPs, by denying patients access to specialist advice. Sleep easy in your four posters, boys, it won't last for ever.

You don't seem to realise, we just get paid a salary - no performance-related pay to bother us

2GPs, £202,000 up for grabs - you do the maths... nice one
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Andrew Mimnagh, GP Partner,
16 Nov 2011
2 Gp's plus 8 more plus infrastructure costs for technology and backoffice support staff. Project budget 202,000. I suspect unlike my anonymous coonsultant colleague most GP's realise you cannot do the maths to derive the sessional remuneration per GP., Perhaps that's why the government realised we are most familiar with business realities and lumbered us with commissioning.
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Anonymous, PCT,
16 Nov 2011
This sounds interesting but GPs should be a bit concerned when they start to talk like bean counters. GPs have had lots of training already - the assumption here is that this training has not acquainted GPs enough with health economics.

The bit that always gets missed in these appraoches is the function of the local health economy. If we continue to focus on activity reduction we need to plan with secondary care to ensure that resources are allocated where needed. As I keep writing - the NHS pays for actual activity and overspends caused (in the short to meduim term) by the removal of it.

PCT Finance Manager
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Anonymous, PCT,
16 Nov 2011
We having being doing this with our GP's for the last 2 years. THe sessions are very popular with GP's but the jury is still out on whether they are improving health care or impacting on referrals as the change in referrals is within the bounds you would expect through natural variation in presentations.
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Anonymous, Practice Manager,
17 Nov 2011
Is there any evidence that a 40% reduction is viable? i.e. that there is excessive un-necessary referrals of +40% ...it seems unlikely in which case the latter cost saving is irrelevant isn't it?
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Esmat Bhimani, Salaried GP,
17 Nov 2011
A complete waste of funds.
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