This site is intended for health professionals only


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

Maximise your practice's financial potential and compare your performance with peers with Pulse Intelligence. Register for a 30 day free trial.