I disagree with the argument in your recent editorial against schemes to incentivise GPs to reduce referrals.
Let’s face it, GPs have never evaluated their referral patterns and behaviour before or asked whether they could have done something differently.
Do we lack knowledge to advise and treat patients differently? Do we fully utilise specialty knowledge within our practices? Do we use NICE referral criteria at all times?
There is room for great improvement before we reach the situation you describe of compromising and devaluing our referral services.
Private companies will be jumping in to take over and make huge savings on the back of GPs’ inability to self-evaluate and change referral behaviour quickly enough.
The outcome for GPs financially and for our patients will be far worse if these companies take over, employ us and then tell us what to do.
Dr Tam Turek, Chippenham, Wiltshire