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Trusts warning of deficits as GP referrals soar again

By Nigel Praities

Dozens of PCTs are forecasting their surpluses will be wiped out if the GP referrals crisis continues, with some even predicting they will breach their statutory duty to avoid end-of-year deficits.

The dire outlook, revealed by the Department of Health last week, came as official GP referral figures for the second quarter showed a 13% year-on-year increase – the second successive big rise.

It has left around 30 PCTs struggling to break even, with a few predicting big deficits, increasing the likelihood that further trusts will adopt controversial GP incentive schemes to cut referrals.

41213723The staggering second-quarter increase means there have been an extra 295,100 GP referrals compared with the same period last year.

The DH revealed the hardest hit areas were NHS Yorkshire and the Humber and NHS London, both with increases in referrals of nearly 17% since last year.

NHS performance figures for quarter two reveal the extent of the hole this has created in PCT finances.

Devon PCT is facing a £14.4m deficit and Buckinghamshire and Hampshire PCTs are predicting a £7.5m and a £5m overspend, respectively.

Pulse revealed last week that trusts across the country were set to report rises of more than 10% in quarter two, but that the rise had been checked in areas with controversial incentive schemes.

NHS East of England's 0.1% reduction, which we reported last week, was the only fall among England's 10 SHAs.

Oxfordshire PCT has reduced its dermatology referrals by 13.8% and ENT referrals by 23.4% from July to September this year after launching its GP incentive scheme.

Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxfordshire LMCs, warned GPs would have to expect more scrutiny of referrals.

‘There is only one pot of money and GPs should collaborate with PCTs to ensure all potential pathways of referral are used appropriately. If a PCT finds itself in deficit things GPs would like to see funded will not happen, so it is in their interests to co-operate.'

Hampshire PCT is conducting a 12-week scheme to get all GPs to vet their referrals. Dr Nigel Watson, chief executive of Wessex LMCs, said the scheme was working: ‘The rise is beginning to stabilise a bit, but it is quite difficult to quantify at the moment,' he said.

Other types of referrals rose by 9.2% from July to September, compared with the same period last year.

Hospital referrals continue to soar, leading to dire warnings of deficits from PCTs Percentage changes in GP referrals

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