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Schizophrenia referrals could overload system

The GPC has warned that urgently referring patients with suspected schizophrenia could swamp secondary care services.

The warning comes following guidance on schizophrenia from the National Institute for Clinical Excellence, released at its annual conference in Birmingham last week, that will set GPs up for a key role in managing patients with the illness.

The guidance said GPs would have to refer patients with suspected schizophrenia urgently to secondary mental health services. GPs may also have to prescribe atypical antipsychotic drugs before the patient has been seen by a psychiatrist if symptoms are acute.

The guidance added GPs would have to monitor the physical health of schizophrenics and arrange regular check-ups, ideally every six to 12 months.

But the GPC said urgent referrals would 'clog up the system' and warned of the

potential for inappropriate prescribing.

Dr George Rae, a member of the GPC prescribing sub-committee, said: 'If everybody goes by the guidelines, there would be an increase in the acute demand within the secondary sector.'

Dr Chaand Nagpaul, another member, said: 'It is quite unacceptable to expect GPs to diagnose and initiate treatment because of delays in access to a psychiatric opinion. Diagnosis and treatment requires specialist expertise.'

Members of the guideline development group said GPs should ensure patients with suspected schizophrenia are ideally seen within 48 hours, but they admitted access to secondary care services was 'pretty variable'.

Professor Irwin Nazareth, professor of primary care and population studies at the Royal Free and University College London and a GP on the guideline development group, said GPs would find it difficult to implement the guidelines because of the lack of time and resources.

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