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Warning on referral centres

The Department of Health’s primary care tsar, Dr David Colin-Thome, issued the warning in a letter sent out earlier this month to PCT chief executives.

The Department of Health's primary care tsar, Dr David Colin-Thome, issued the warning in a letter sent out earlier this month to PCT chief executives.

‘First and foremost, the vision and function of a referral management scheme (RMS) must be developed and agreed with practice-based commissioners,' he wrote. ‘The RMS should not, for example, prevent a practice-based commissioner from developing alternative schemes.'

Such schemes should become less common as PBC reduced the reliance on secondary care, Dr Colin-Thome added. ‘Finally, while the referral from GP to consultant will remain a key component of care, referral to other clinicians has equal value.'

Dr James Kingsland, chair of the National Association of Primary Care, welcomed the intervention. ‘I would say the majority of schemes have been set up and designed by PCTs with little clinical input and add very little value.

‘The ones that do add value – we know of a good example in Kingston, Surrey – are clinically led, driven by GPs, get feedback about the referral's quality and what more could be done before referring.'

Dr David Colin-Thome; referral management schemes must be developed in conjunction with PBC consortia Dr David Colin-Thome; referral management schemes must be developed in conjunction with PBC consortia

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