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Referral rates differ widely

Referral rates in GP practices in affluent areas of London are 50 per cent higher than they should be, and practices in deprived areas are significantly under-referring, figures from Dr Foster reveal.

The analysis, gleaned from the company's new practice-based commissioning tool, shows London PCTs' use of outpatient services does not reflect the relative levels of need among different groups in the population, according to age, sex and a weighted expected number of first attendances.

Referrals in Newham, Islington and Harrow were well below the average, while those in Enfield, Richmond and Twickenham and Barnet dramatically exceeded the average rate of


Nine PCTs were over-referring by up to 25 per cent; five were over-referring by up to 50 per cent.

Seven PCTs were under-referring by up to 10 per cent; a further three were under-referring by up to 24 per cent. Figures were taken from September to December 2005.

Roger Taylor, research director at Dr Foster, said the figures showed NHS money was being used ineffectively in some areas but said the data could help practices better allocate their funds and see where patient care needs improving.

'It's a reality check,' he said. 'The main point is there are wide variations in referral rates between areas. GPs need to consider whether they are happy if they have high referral rates.'

The Department of Health said the tool would help clinicians 'to help every patient get the care that is right for them'.

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