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PCTs re-route referrals to independent sector

By Rob Finch

GP referrals are being re-routed to independent sector treatment centres behind the backs of GPs.

Referral management centres in at least three LMC areas are phoning 'significant' numbers of patients and pressurising them to switch from referral at an NHS trust ­ where they expect to see a certain consultant, often at the recommendation of their GP ­ to independent sector treatment centres.

GPs said the pressure, driven by a desire to save money by filling block contracts with private providers, undermined the doctor/patient relationship and the precarious financial situation of local hospitals. Medicolegal advisers said the approach undermined patient autonomy.

GPC chair Dr Hamish Meldrum said the practice was unacceptable, and rode roughshod over patient choice.

'It's not what referral management is all about. I would be interested to hear Number 10's views on this,' he added.

LMCs are concerned GPs could be blamed for problems relating to 'diverted' referrals.

Somerset LMC is instructing GPs to attach a disclaimer to any referral that is made directly to a named consultant, warning that 'any medical, legal or process complaint arising out of a diversion of this referral will be the responsibility of the chief executive of the PCT authorising this action'.

Dr Harry Yoxall, secretary of the LMC, said: 'They have been perhaps overzealous and will ring even when we have made our referral decision clear.'

Dr Nigel Watson, chief executive of Wessex LMCs, said GPs and patients would face further pressure. 'Practices will also be leaned on to refer in a particular way,' he said.

Dr Terry McCormack, a GP in Whitby, north Yorkshire, confirmed patients were experiencing pressure to use the independent sector treatment centre. 'It pulls the rug from under

local hospitals' feet,' he said.

Dr Nick Norwell, medicolegal adviser for the MDU, cautioned GPs to keep clear notes and warn patients about referral management centres and the actions they might take.

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