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Referral management scheme declined almost a tenth of GP requests


(1)There is a fine line here between improving the quality of referrals and the ideology of throwing a patient forward and backward . Under the current ‘toxic’ working conditions of GPs , the latter certainly will add another caveat to the narrative of general practice being unsafe(the upper limit of how many patients a GP should see daily , prescribing mistakes, opiods/gabapentinoids etc). (2) Once referral management(RM)becomes the ‘social norm’ in NHS , it is a no-return road . More robust RM will feed the political narrative/incentive of cutting further resources in secondary care (or even closing more hospitals while I would argue we actually need more hospitals). (3) It is also about transferring responsibility from A to B and back to A like a boomerang. I would argue that the RM doctor should personally pass the referral to an alternative clinician(e.g. GPSI) other than specialists in secondary care if he/she deems necessary. If a simple treatment is indicated, he/she should initiate the prescribing for the patient. And if he/she thinks there is no indication to have any specialist opinion(e.g. treatment not covered by NHS),he/she will send a letter of explanation to the patient. Yes , do not judge the book by the cover but the judgement also does not sustain without properly balancing the benefits and risks , and more importantly, analysing the current political circumstances . Ultimately, deep down ,we all know where the root of the culpability lies for these’ circumstances’ we are under .

Posted date

17 Mar 2018

Posted time