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GPs told to ignore choice and refer to Care UK services

By Ian Quinn

Exclusive: GPs are being told to refer thousands of patients to the private sector to bail out a Government scheme to outsource services from hospitals, Pulse can reveal.

A group of 10 PCTs is insisting practices send patients to services run by the company Care UK, after it emerged they were currently seeing fewer than a third of the projected number of referrals.

GPs have been warned they could even face action from the GMC if they refuse to refer patients en masse to the company.

Trusts who will foot the bill from the Department of Health's contract, which pays Care UK a block sum even if services are under-used, are warning they face dire financial consequences if they cannot ensure GPs refer to the private facilities rather than local services.

It comes after Derby City PCT admitted offering payments to GPs to send patients to an independent sector treatment centre in its area.

The latest move has outraged some GPs, who claim it makes a mockery of the Government's choice agenda and health secretary Andy Burnham's claim that the NHS is its ‘provider of choice'.

Care UK won a seven-year contract to provide general surgery, ENT, gynaecology, urology and orthopaedics services across 10 PCTs in Greater Manchester, through an independent sector clinical assessment and treatment service (ISCATS). But the services, launched last year, have attracted just 25-30% of anticipated numbers.

A letter sent to GPs in NHS Heywood, Middleton and Rochdale – which alone faces a £2m funding crisis – said: ‘Unless there are compelling reasons, all patients will be referred to ISCATS on the advice of their GP during a choice discussion'.

Dr Nick Dawes, medical director of NHS Heywood, Middleton and Rochdale, told Pulse: ‘The CATS contract was a DH contract that we had very little input in. We've now got to maximise the capacity in our commissioning of the service and we've been having robust conversations with GPs. It's incumbent on them as part of their registration with the GMC to use resources efficiency. My understanding is some PCTs are considering mandating it.'

GPs in Greater Manchester have been told to use Choose and Book to direct patients to the Care UK service.

Ironically, ISCATS was originally envisaged as a mandatory pathway for referrals but this was overturned by the Government's choice agenda.

Dr Ravi Mene, secretary of Salford and Trafford LMC, said: ‘PCTs are trying to force GPs to refer to ISCATS. I would rather refer to my local hospital and make sure it survives.'

Dr Michael Taylor, a GP in Heywood, said: ‘Some GPs feel this impinges on their clinical freedom. I am sure it wouldn't have happened unless there was a financial imperative.'

A Care UK spokesperson said its services meant patients being seen closer to home, with ‘state-of-the-art diagnostic pro-cesses' and ‘much shorter waiting times than in hospital'.

GPC negotiator Dr Chaand Nagpaul said: ‘This situation is a result of a politically driven procurement of the private sector by the Government.

‘Forcing GPs to refer to a private provider flies in the face of the Government's rhetoric around patient choice and wholly contradicts Andy Burnham's claims that the NHS is the preferred provider.'

The BMA last week launched a PR campaign urging patients to rally against privatisation, claiming providers are receiving millions in guaranteed payments for contracts, even when under-used. BMA chair Dr Hamish Meldrum said: ‘As the public purse-strings tighten, it is crucial that public money is no longer wasted on expensive commercial experiments.'

Dr Chaand Nagpaul