Exclusive A hospital has told GPs to delay referring patients with suspected cancer for two-week referrals if they are unable to make a specific appointment, as managers attempt to bounce even urgent referrals back to primary care to avoid breaching waiting-time targets.
At a meeting last month of Berkshire LMC, GPs claimed that in cases where patients were unable to attend two-week referral appointments for personal reasons, the Royal Berkshire NHS Foundation Trust had asked them to write a letter ‘stating that the patient does not need to be seen’.
The hospital trust denied it had specifically requested GPs write such a letter, but admitted it had urged some two-week referrals be delayed ‘to achieve the best patient experience’.
A spokesperson for the Royal Berkshire NHS Foundation Trust said: ‘Occasionally patients given urgent appointments fail to attend on the day because they are unavailable through family commitments or holidays. This means we cannot see them within the two-week deadline. What we are suggesting to GPs is that where a patient knows they will not be able to attend an appointment within the next two weeks, perhaps it would be more appropriate to refer them as soon after their previously arranged holiday or family commitment.’
But Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxfordshire LMCs, told Pulse: ‘This is the perverse effect of targets. People start playing games if targets are likely to be breached.
‘If a proportion of patients breach the two-week wait because they can’t attend, then the trust doesn’t like it because it looks bad on their wait statistics. It is a clinical nonsense.’
Dr Tony Grewal, medical director at Londonwide LMCs, said hospitals had developed a culture of ‘GP to chase’: ‘In one case there was a delay of several months for what turned out to be prostate cancer.’