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GPs face cap on number of vasectomy referrals

Exclusive GPs have been told they can only refer a limited number of patients to undergo vasectomy under plans to cut referral costs, Pulse can reveal.

Practices in Basildon and Brentwood CCG have been told they face a cap on how many GP referrals for vasectomy they can make in 2015/16, with three practices told they can refer just one patient each this year.

In a leaked letter, the CCG said it had made the decision after reviewing past ‘activity and spend’ on vasectomy services.

But GP leaders said the move was ridiculous and the CCG should consider reversing the plan.

The letter, dated 23 April, stated: ‘The CCG’s clinical executive committee has today reviewed the CCG’s activity and spend in relation to vasectomy services. Following this review the CCG clinical executive has taken the decision to cap the number of referrals for vasectomies each member practice can make.’

It added: ‘Please note that with immediate effect, CCG member practices can only refer to one of the CCG’s contracted providers of vasectomy services, and CEG have agreed that the number of reerrals will be capped.’

An accompanying list details the number of vasectomies each practice is permitted to refer in 2015/16 – ranging from one to 11 per practice.

It comes as CCGs in several areas are known to be drawing up plans to ration services such as hip and knee surgery, although Devon commissioners recently backed down on plans to restrict access to routine surgery for obese patients and smokers, and to ration hearing aids, following protests.

Dr Richard Vautrey, deputy chair of the GPC, said the CCG was risking unwanted pregnancies for the sake of a ‘few pounds’.

Dr Vautrey said: ‘This is a ridiculous short-term decision that could have huge long-term emotional and financial consequences to both families in the area that the CCG serves and to the wider NHS as other services have to pick up the pieces.

‘For the sake of saving a few pounds the CCG is taking the risk of a rise in unwanted pregnancies and all that means for individuals and families and they should seriously consider reversing this decision.’

Dr John Chisholm, former GPC chair and president of the Men’s Health Forum, agreed the approach could not be justified on clinical or cost-efficiency grounds.

Dr Chisholm said: ‘I believe it’s an inappropriate and wrong-headed decision that is neither in the interests of patient nor of GPs’ clinical decision making. At the worst obviously it could result in an unwanted pregnancy which would itself have undesirable consequences.

He added that the financial savings involved ‘would likely be pretty tiny’.

‘All CCGs are facing difficult decisions, nonetheless I think CCGs need to be concentrating on inappropriate use of resources and referrals rather than try to cap completely appropriate referrals,’ Dr Chisholm said.

Basildon and Brentwood CCG said in a statement: ‘The CCG has difficult decisions to make to ensure that it meets its statutory obligations. The decision has been taken to cap this years’ spend at the 2014-15 level. The number of referrals that each practice can make is based on their list size.

‘Referrals can be made to providers who were successful in obtaining a contract with the CCG following an open procurement process last year.’


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