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Paper referrals returned as hospitals battle wait target

Hospitals are returning paper referrals to practices if they cannot offer patients an appointment within the Government's 13-week waiting time target, writes Ian Cameron.

The block on manual referrals comes in addition to Choose and Book restrictions which are stopping GPs referring patients to popular hospitals if they have longer waits (Pulse News, 10 August).

In response to Pulse's disclosure of the Choose and Book restraints, the Department of Health advised GPs to submit manual referrals for patients preferring to wait longer for their first-choice hospital.

But even these are being returned, with GPs told to refer the patient elsewhere.

Dr Nigel Watson, chief executive of Wessex LMCs, said he had had three 'manual' referrals returned in the past three months ­ a high proportion given he only consults two days a week ­ and was getting similar reports from across his region.

He said: 'Even if a trust is unable to offer an appointment in 13 weeks, if that's really where they want to go can they not [be excluded from] the target?'

GPs in Salford said hospitals wrote to patients after having received GPs' manual referrals saying they were unable to offer a slot within 13 weeks and they would be in touch 'in the future'.

Dr Ravi Mene, Salford and Trafford LMC secretary, said: 'Wait times can easily go beyond 13 weeks. Waiting times for psychology are between nine and 12 months.'

Avon LMC said the United Bristol Hospitals Trust had indicated paper referrals would be treated in the same way as those made via Choose and Book.

Steve Mercer, Avon LMC chair, said he was investigating whether hospitals would breach their duty of care towards patients by sending referrals back.

He said: 'It is wholly unacceptable.'

The department said it was not 'acceptable practice' for providers to return any referral without a valid clinical reason. It would 'reinforce' this with managers, a spokeswoman said.

She said: 'Providers must continue to accept all clinically appropriate referrals and manage capacity to ensure patient outpatient appointments are made within 13 weeks.

'A trust cannot remove itself from the choice menu or return the referral because it will breach access standards.'

GPs said the department's advice to make manual referrals in itself ran contrary to its target for GPs to make 90 per cent of referrals through Choose and Book by March next year.

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