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Patient safety a priority as doctors face increasing pressure to help PCTs bring rising deficits under control

GPs stand firm over referral cuts

By Joanna Clarke-Jones

GPs are warning NHS managers they will not jeopardise patient safety in order to help PCTs bring their fast-rising deficits under control.

Figures released last week showed the NHS' financial position has worsened in the past three months, with PCTs the worst-performing sector.

The number of organisations predicting deficits has risen to 175 from 120 three months ago. Overall, the NHS is on track to be £1.18bn in the red by the

end of the financial year, the

Department of Health's six-month figures show.

Hillingdon PCT has racked up the largest debt of all NHS trusts, and is now forecasting a £65m deficit – 26 per cent of its turnover.

The newly merged Cambridge PCT has forecast a £33m deficit and North Norfolk PCT's overspend has doubled from £8.7m to £16.5m – 14 per cent of its overall turnover.

PCTs have targeted cuts in GP referrals as a means of saving money and are looking to practice-based commissioning to help drive through the policy.

Dr Pauline Brimblecombe, a Cambridge GP involved in a 30-strong commissioning group, said local GPs had cut referrals by 14 per cent but the trust was demanding 25 per cent.

She warned that patient safety had to be GPs' priority: 'They can only push us so far.'

Dr Brimblecombe blamed the 'unfair' funding formula that gave more affluent areas less funding for the deficits.

She added: 'The problem is that the government is telling us to demand manage at the same time as telling patients they have free choice.'

Dr Paul Roblin, chief executive of Thames Valley LMCs, said GPs had to co-operate with trusts to help alleviate the debt but would have to use their judgement to ensure what they did was clinically safe.

Dr Laurence Buckman, GPC deputy chair, said he did not

expect the financial crisis to

affect GP pay negotiations.

The BMA has demanded a 4 per cent pay rise for GPs and other doctors, but the Department of Health has said only 1.5 per cent is affordable.

Dr Buckman said: 'We have an agreed position. The NHS deficits are many, many times larger than what it has been agreed to pay GPs.'

NHS chief executive David Nicholson said the NHS was still on track to deliver net financial balance, as strategic health authorities had an extra £100m in contingency funds.

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