The front page of Pulse last week reported some alarming developments, with some GPs limited to as few as four referrals a week.
It seems referral restrictions are being introduced all over the country with a potentially dangerous focus on quantity, rather than quality.
In east Suffolk we have shied away from triage by GPSIs and referral management centres, and moved to enable local consultants to advise us on how and where to best support our patients.
Every referral in an initial seven specialties is now assessed within three days by a consultant through special functionality on Choose and Book.
They then allocate either a hospital or community clinic appointment, or are paid to write us a community management plan.
A referral is not a request for a patient to be seen in hospital, but a request for advice on how and where to best manage a patient.
In the first year this project has brought a 23% saving in urology and gynaecology outpatient appointments.
Your editorial reminds us that we are all in clinical commissioning groups (CCGs), albeit with varying degrees of enthusiasm.
Collective responsibility for the prudent spending of public money is an opportunity to implement a method of managing referrals that is driven by quality, not quantity, and that draws primary and secondary care closer together for the benefit of our patients.
From Dr John Havard
Lambsale Meadow, Suffolk