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Patient choice ‘has changed GP referrals’

GP referral patterns have been ‘significantly changed' by the introduction of patient choice, concludes an analysis by UK economists that shows almost half of patients do not opt to have an operation at their nearest hospital.

The study looked at all the hip replacement referrals in 2006 to 2008 and found although 90% of patients had a hospital located within 20km of their home, four in ten preferred to travel further afield.

It also found distinct changes in GP referral patterns with 95% of all GPs making referrals to a maximum of three different hospitals in 2003/6. This had decreased to 75% in 2008/9.

The study will come as welcome news to the Government, after Pulse revealed in March that the DH were investigating a sharp fall in Choose and Book usage from 57% two years ago to around 50% in January 2012.

The researchers tracked almost 40,000 patients using the Hospital Episode Statistics database and found patients preferred hospitals with lower mortality rates and shorter waiting times, as well as valuing low infection rates of MRSA and a high rating from the CQC.

GP recommendations also had a large impact on patient choice; patients tended to choose hospitals that had high past-referral rate from their GP.

The report, published in this month's edition of The Economic Journal, concluded: ‘We take this to suggest that there has been a significant change in GPs' referral patterns after choice was implemented in 2006.'

‘Patients in England do take quality into account when making their choice of hospital, which is fundamental to the success of the policy of patient choice.'

Dr Peter Bailey, a GP in Great Cambourne, Cambridgeshire said: ‘People will look at all the stats they can get hold of, but it's also about the culture of the place they live.

‘If all their friends have gone to a hospital, they'll go. Familiarity, knowing the hospital, having been there before and being confident about getting there and parking are all things which patients care about a lot.'