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We need to be able to refer, not defer



I thought the barrel-bottom of CCG bright ideas had been well and truly scraped a few years back – when local blue-sky-thinkers suggested sending GPs into our DGH to discharge patients from wards if they didn’t really need to be there. But no. Because now we have this brainwave from NHS St Helens CCG suggesting that GPs might be blocked from making routine referrals for four months or so. Because, you know, winter’s busy in secondary care, and heck, patients won’t mind (though apparently you do have to check).

I’m starting to think I might be a bit of a simpleton because I really don’t get this, despite furiously scratching my head for the last few days. And I don’t get it on a number of levels:

  1. We have a contractual obligation to refer as and when we deem it necessary. So we can’t not. A referral is a referral, not a deferral.
  2. We have quite enough medicolegal jeopardy already, ta.
  3. If we have to put patients in limbo, why does that have to be located in, and the responsibility of, GPs?
  4. It doesn’t solve this problem, it just boots it unceremoniously down the road.
  5. This is the thin end of an ethically dodgy wedge. Which ends – if you really want to extrapolate on a long but entirely logical continuum – with us culling selected punters every autumn on the basis that it’ll be the only way to cope with the inevitable winter pressure. You know, thinking outside the box even if it involves putting the patient in one*.

Listen, chaps, the system’s broken. And if it’s broke, do fix it, right? Someone? But don’t sweep it under a four month–sized carpet – knowing that you might be caught red-handed, holding the broom.

* So long as they don’t mind. Remember to check that.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield