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PCOs put cap on GP referrals

By Alisdair Stirling

Exclusive: NHS managers are imposing emergency caps on GP referrals and threatening to delay some procedures until next financial year in a desperate attempt to avert financial crisis.

A string of primary care organisations plan to clamp down heavily over the coming weeks on GPs’ freedom to refer patients in response to mid-year financial reports forecasting huge end-of-year debts.

NHS South West Essex is predicting a £43m deficit by the end of this financial year and has identified cuts in GP referrals as essential to its hopes of balancing the books.

Every single GP referral – with the exception of those under the two-week rule – will be scrutinised by a new referral management centre, to decide whether it should go ahead and if so how quickly. The trust warned GPs it planned to delay a raft of hospital activity scheduled for the end of the financial year until 2011/12 to artificially reduce its deficit, admitting much of its final-month activity could be deferred. It is suspending access to in-vitro fertilisation until April.

Elsewhere, NHS Richmond plans to limit overall GP referrals to a level 5% below current rates by tightening referral criteria for a series of hospital procedures, including hip and knee replacements, removal of cataracts, tonsillectomy and insertion of grommets.

A spokesperson for NHS Richmond insisted: ‘Almost all GP practices are fully engaged.’

NHS Manchester has launched a ‘referral gateway’ manned by GPSIs, who will manage referral costs.

The trust said: ‘Activity has been going through the roof. GPs have been working with us on this – we think it’s vital.’

NHS Hounslow said it planned a ‘referral facilitation service’ to supplement referral management and ‘encourage GPs to reflect on their referral practice’. NHS Redbridge plans savings of £800,000 in 2010/11 by reviewing GP referrals.

Dr Brian Balmer, chief executive of Essex LMCs, said the NHS South West Essex scheme had been introduced with no formal consultation: ‘The PCT has got itself in a most appalling financial mess. I hope disruption to patients will be kept to an absolute minimum.’

PCOs put cap on GP referrals