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GPs secure funding for peer review of referrals

GPs have been handed a huge cash boost by their CCG to help them cut their referrals by peer education and support without the need for draconian referral management.

The scheme, set up in Hertfordshire by Herts Valleys clinical commissioning group, has been awarded 202,000 funding from the regional innovation fund to develop support for GPs.

It will involve setting up specialist programmes for each of the top ten specialties – trauma and orthopaedics, dermatology, cardiology, ENT, gynaecology, ophthalmology, urology, gastroenterology, rheumatology and neurology – which together accounted for nearly 60,000 first outpatient attendances across the CCG last year.

Lead GPs in each specialty will lead and provide peer-education via virtual surgeries, web resources and educational events as well as ‘up-skilled’ GPs in every large practice.

The CCG – which covers Dacorum, Hertsmere, St Albans & Harpenden, Watford and Three Rivers localities – will encourage smaller practices to federate so that each group of smaller practices has access to an expert GP. All GPs will receive feedback about their referral patterns so continuous learning takes place.

The project will initially establish two lead GPs, followed by another eight. The leads will each receive a budget to fund their on-going development, identification of referral patterns, liaison with leads at locality/practice level, and identification of best practice including care pathways.

It will also fund virtual surgeries running over a six month period so that clinicians can email or telephone with questions about referrals, the development of frequently asked questions and answers logs, and the designing of educational events for clinicians and patients. The project will be evaluated in March.


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Dr Jayne Taylor, performance management director at Hertsmere Commissioning Locality, said: ‘CCG referrals resulted in 59,827 first outpatient appointments – at a cost of £9,434,815′ in the top ten specialties last year across Herts Valleys.

Dr Taylor added: ‘A reduction of 10% across each specialty would save £943,480 and a reduction of 40% across each specialty would save£3,773,912.’

The scheme would also cut follow-up appointments – which totalled 201,615 in the ten specialties last year – as well as reducing investigations in the acute sector, cutting emergency referrals and reducing days lost from  work and unnecessary travel for patients and their employers as well as efficiencies in GP and practice nurse time, she said.