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Patients at risk as referral gateway triages TIAs and ‘breast symptoms’

Exclusive A referral management centre has been controversially screening GP referrals for transient ischaemic attack or stroke, and for ‘breast symptoms', in moves experts warned could dangerously delay assessment of patients in hospital.

NHS Ealing's referral gateway was screening referrals in those areas until April 2011, when it added them to its ‘exception list' following what it claimed were ‘changes to regional and national policy'.

The PCT said that U-turn, implemented at the start of financial year 2011/12 and revealed under the Freedom of Information Act, was not linked to a serious untoward incident at the referral gateway – one of three nationwide revealed by Pulse last week.

But GPs warned that channelling TIA and breast symptom referrals via a referral gateway would delay urgent referrals and put patients at risk.

Dr Michelle Drage, chief executive of Londonwide LMCs, said the change in policy was ‘a really positive move': ‘I suspect it's because CCGs and GPs locally have been making moves that this would be in the interest of patient care.'

Dr Stewart Findlay, a GP in Bishop Auckland and chair of Durham Dales CCG, said: ‘Most TIAs will need to be seen probably within two weeks and some more urgent than that. It is not suitable for the delays a referral management centre would put into place. 

He added: ‘There will be some women who have lumps but not breast cancer. However, the move in our area is to ensure breast clinics see all women with lumps as rapidly as possible, because you can't tell simply by looking or feeling whether someone has breast cancer or not.'


RCGP chair Dr Clare Gerada will answer your questions live on PulseToday tomorrow. Logon between 2pm and 3pm to quiz Dr Gerada - or click here submit your queries.