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GP referral cuts a ‘catastrophe’ for hospital finances

Exclusive Hospitals are suffering a ‘catastrophic' loss of funding because of plunging rates of GP referrals as NHS managers block access to services, Britain's most senior consultant has told Pulse.

Dr Mark Porter, chair of the BMA consultants committee, said the fall in referrals coupled with other factors such as tariff restrictions was forcing hospitals to consider mergers or cut access to ‘whole parcels of services'.

His comments came as the Foundation Trust Network, which represents hospital managers, pledged to investigate the effect the sharp fall in GP referrals in the first quarter of this financial year was having on secondary care finances.

GP referrals dropped by an average of 4% in the last quarter compared with the same period the previous year, with falls of up to 37% in areas with controversial schemes to restrict referrals.

Dr Porter said: ‘This is proving a catastrophe. I know of hospitals coming off the FT pipeline, hospitals being forced to consider merging, hospitals being forced to restrict whole parcels of services, and many of the reductions in referrals are to do with the low-priority procedure lists.

‘Some of the reconfigurations will be appropriate. But it's impossible to know which are appropriate and which are prompted by inappropriate resource restrictions.'

A snapshot Pulse survey of clinical commissioning group leaders found most expected hospital finances in their area to be hit by reductions in referrals, and seven out of 10 believing closures or reductions in capacity would follow.

Dr Amit Bhargava, GP in Crawley, West Sussex and chair of Horsham, Crawley and Mid Sussex CCG, said:  ‘We're trying to reduce demand and that does have an impact on our local hospital - though that is welcome at the moment as they are having difficulty coping with the numbers of patients in both planned and unscheduled care.'

Dr John Ribchester, a GP in Whitstable, and chair of the Whitstable Practice CGG, said:  ‘It is likely there will be closure of outreach outpatient departments in community hospitals.'

The Department of Health hailed the drop in referrals – the first in six years - as evidence the NHS is ‘working more effectively and more efficiently'.

But a spokeswoman for the Foundation Trust Network said it would investigate the effect on its members' finances: ‘We don't have any evidence on how it could be affecting providers, but we are planning to look at this area in the near future.'