Pulse survey shows GPs are in the front line of NHS financial cutbacks
Scale of pressure to cut referrals revealed
Pressure on GPs to cut their hospital referrals is intensifying as the NHS gets ever more desperate to rein in mounting deficits, a Pulse survey reveals.
Almost seven GPs in 10 are being subjected to policies aimed at cutting their referrals, with some facing attempts to cut them by more than 20 per cent.
Referral management centres are the most popular method being used by PCOs. Some 53 per cent of GPs said their referrals were now going via these centres.
Stopping named consultant referrals (45 per cent) and using standardised referral forms (35 per cent) were the next most-used restrictions.
'There is no evidence to show new methods such as the referral management system work,' said Dr Thomas Nichols, a GP in Oxford.
'Letters get lost, or we have to make several referrals. There is no way to know the impact
on health, but there is a big
nuisance factor for GPs and
Dr Mohammad Mustafa, a GP in Fareham, Hampshire, said: 'I have been trained to know what a patient needs and I am upset that my decisions are being challenged because of money issues.'
One GP in four had been set a specific target to cut their referrals by their PCO.
Dr Douglas Moederle-Lumb, a GP in Scarborough, said cuts of 20 to 30 per cent were being demanded by North Yorkshire and York PCT.
He said: 'Our practice has looked at this carefully and our referrals have not been inappropriate. I am happy to co-operate with the PCO but there must be satisfactory alternatives available. It has created huge bad feeling among GPs.'
Orthopaedics, where 44 per cent of GPs were having difficulties, and mental health (27 per cent) were the specialties where GPs experienced most problems.
More than a third of the first 185 respondents said it was increasingly difficult to refer to a hospital of their choice.
Dr Richard Vautrey, GPC negotiator and secretary of the LMC in Leeds, where PCTs have pushed more follow-ups into primary care, said trusts needed to consult GPs on referrals policies.
He said: 'If PCTs work with their GPs from the start, and identify where patient care will not suffer, and may even be enhanced by new referral procedures, then they will have more success in changing practice.'