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Trust seeks GMC advice on payments for cutting referrals

By Tony Lithgow

A PCT is seeking GMC guidance on its referral incentive LES after a wave of outrage from GPs and patients over controversial schemes rewarding practices for cutting referrals.

Devon PCT's decision to write to the GMC, which it said followed ‘an increased awareness in the media' about such schemes, comes as SHA bosses gave the green light to a similar scheme in Hampshire.

A Pulse snapshot survey last week found 85% of GPs believe financially incentives for reducing referrals are ethically unsound, with 78% saying they put patient care at risk.

In a joint letter from Devon PCT and LMC, local GPs were told: ‘The PCT and LMC jointly support all components of this LES being offered to practices. However we do wish to brief the GMC on our proposals and will be doing this over the next few weeks.'

‘The PCT and LMC don't envisage that this will cause any problems in the participation of the LES.'

Dr David Jenner, an executive member of the NHS Alliance and GP in Cullompton, Devon, said: ‘The new incentive schemes present a specific new situation not covered by previous guidance."

‘We would welcome guidance as to whether reward monies can be offered as cash or whether this should be re-invested in patient services under the scrutiny of the PCT.'

However a GMC spokesperson said it was still considering whether to issue further guidance.

Meanwhile South Central SHA has given a cautious go-ahead to a similar scheme in Hampshire – despite a warning last month from the Department of Health that ‘no PCT scheme should undermine – or be perceived to undermine – GPs' overriding duty to individual patients.'

Dr Nigel Watson, chief executive of Wessex LMCs, said: ‘The LMC's position remains that it would wish more emphasis on the review and payment for work done and less on an incentive payment. The incentive payment always ran the risk of being misinterpreted.'

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