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Dr Brian Balmer: This bonkers scheme is piling work on GPs

The extra hassle caused to GPs and patients is ‘bonkers’, says north and south Essex LMC chief executive Dr Brian Balmer, as CCGs crack down on consultant-to-consultant referrals.

It seems a bit bureaucratic for patients to be sent back and forth to the GP. I would have thought some audit system would save the GP and patient a lot of running around. In my opinion, the CCG needs a neater system.

Obviously this is creating an increased workload for GPs. They’re already bursting at the seams and this is piling on more work. It makes us look inefficient. It gives the patient a lot of hassle. The  whole system, it’s a market from hell.

I’ve had a referral to dermatology which was returned to me after a month saying ‘please send this to two week referrals’. Fine, I’ve got it wrong. But I got that letter telling me I’d got it wrong after a month, and then had to refer again. The patient waited over four weeks. They should have just referred it straight on. It’s bonkers!

Dr Brian Balmer is chief executive of north and south Essex LMC

Readers' comments (6)

  • The NHS is bonkers completely. This system has existed in NI for many years. Patients either need to be seen or not. They go round and round on managerial whims and wait for hours on trolleys on years on waiting lists. That is how they pay - not in cash, but with time, suffering and sometimes with their lives.
    Better to pay a small fee if it would improve staff levels and overall waiting times. People have lay dead on trolleys in A+E without anyone noticing. This is the NHS,

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  • Sorry Brian, what have you learnt from this experience? Yes you got the letter from the consultant after a month. Yes you acknowledge that YOU got it wrong in the first place by not doing a 2 week referral. What assurances do the public have that this WILL NOT occur again in the future?. You might call this being bureaucratic, but is necessary to drive up standards.

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  • Given that it is the CCG / practice commissioning budget that pays for the referral then presumably GP's and CCG's need assurance that it is being spent properly and not being used as a good income generator at the provider. It wouldnt be the first time this has happened, hence why these schemes existed in PCT days too.

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  • We cannot have patients floating about from one consultant to another on a whim which is what has been happening and costing CCGs money! In some cases patients were being referred by one consutant to another totally inappropriately and unnecessarily! However we have written into our policy that if a consultant thinks the patient needs to be seen by another consultant for an urgent reason such as possible malignancy etc then they are indeed allowed to refer to another consultant to ensure the patient is given the correct and safe care in the shortest possibe time!

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  • David Bush

    There are very good reasons for having a C2C policy, and in our CCG it is saving vast amounts of money. The challenge is to make it user-friendly for patient, GP and secondary care, and I am sure that we can make improvements here.
    Personally, if I receive a letter from a consultant requesting referral to another, and if it is appropriate, then I ask my secretary to send a copy of it to the second consultant with a brief covering note. It takes only seconds of my time.
    Conversely, I receive a lot of requests that are inappropriate as they relate to primary care conditions (depression, memory loss, rashes, joint pains etc etc).
    The more we as GP's engage with the improvements our CCG's are working on, the more gain there will be for clinicians and patients alike.

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  • So what about the letters that say "Thank you for referring this patient via Choose & Book to me at St Loadsamoney's Private Hospital. He/she/it needs a scan/heart transplant/wart removal which we can't do here so please refer to me again at Ditchwater General..."? C2S (Consultant to Self), more like, and another new referral fee for the provider.
    Hmm. Bonkers? Yes.

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