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Jump in private referrals after GPs are told to ask patients about insurance

Exclusive CCGs in one area of England are giving GPs a ‘gentle reminder’ to ask patients to consider using private health insurance if they have it, in a bid to save money on NHS treatments.

NHS Mid Essex CCG told Pulse that it has seen a 6% increase in referrals to private healthcare since it wrote to practices asking them to discuss with patients how they can use private insurance.

Meanwhile, NHS Basildon and Brentwood CCG last week sent posters to practices to display under its ‘Private Healthcare; another patient choice’ scheme, and encouraged GPs to ask about patients’ private healthcare options.

Both CCGs say that the schemes have been introduced in a bid to cut costs.

GP leaders criticised the schemes, warning it may lead to patients feeling guilty for using NHS services, and would increase health inequalities.

NHS Mid Essex CCG is part of one of the 11 most financially challenged health economies in the country. As such, a spokesperson said, it was ‘having to consider options for gaining maximum benefit from limited NHS resources’.

Its scheme began in November 2015, when it wrote to practices to ‘seek their support in specifically discussing with patients who have private healthcare cover, how use of the cover would affect their care pathway’.

The spokesperson added: ‘We have seen an increase of referrals to private healthcare of 5.75% in the first six months of 2016 compared to the same period in 2015.’

The letter from NHS Basildon and Brentwood CCG, sent last week and seen by Pulse, asks GPs to display a patient leaflet, which is headlined: ‘Do you have private healthcare cover?’ and explains that ‘as part of a local NHS project your GP may ask you if you have private medical insurance’.

It also asks GPs to pose the question about private health cover ‘simply to highlight the option for the patient to make a considered choice but by no way impeding on their ability to choose’.

A spokesperson for NHS Basildon and Brentwood CCG told Pulse: ‘In order to meet our statutory obligations to balance our books we have had to consider all available ways to reduce costs’.

They added the policy was a ‘gentle reminder to patients to inform their GP of their private health insurance carries potential benefits for both the patient and the local health economy during this time of financial constraint’.

The CCG was ‘not expressing a view on whether people should have private health cover or not’, they added.

NHS Basildon and Brentwood CCG is also in the process of consulting on rationing a number of services, including a complete ban on bariatric surgery and stopping all vasectomies and female sterilisations on the NHS, in a bid to tackle a £14m deficit.

Dr Andrew Green, chair of the GPC’s clinical and prescribing committee, said he would not encourage patients to use health insurance ‘as all patients have a right to NHS care and should not be made to feel guilty about using it’.

Dr Green added that ‘a further unintended consequence will be that patients already lucky enough to live in an area where large numbers of people can afford private health insurance will gain compared to those in more deprived areas who already suffer worse health, so this is hardly a step towards reducing inequality’.

Dr David Wrigley, deputy chair of BMA Council and GP campaigner against privatisation of the NHS, said: ‘It is a sad state of affairs when GPs are asked by their CCGs to encourage patients to use private healthcare for their illnesses. Surely, with their own GP suggesting this, it will make patients think the NHS is not coping and lead to them seriously consider purchasing costly private health insurance.’