GPs paid to cut patient referrals

The increase in referrals could cause a breakdown in the system, doctors say

Doctors in Oxfordshire have been offered money to reduce the number of patient referrals in a bid to recoup a £23m projected budget overspend.

The county's primary care trust said it had seen an "unprecedented increase in patient referrals" which could cause the local system to "break down".

A new scheme gives money to GPs to re-examine the case files and only send them on when absolutely necessary.

The PCT said it aimed to keep costs down but patient services high.

Dr Rickman Godlee, chairman of Oxfordshire Local Medical Committee, which represents local GPs said: "There is potential for £23m overspend from hospitals from seeing so many patients.

"As a way of keeping the health economy within budget, GPs were asked to take on extra work of looking at referrals."

"If they continued at this rate then the whole of the system will break down - there is not enough money for primary care services."

That's not to say patients who need to be seen by a specialist will not be - of course they will Dr Rickman Godlee Oxfordshire Local Medical Committee

The solution the PCT came up with was to ask doctors to take a second look at patient's files before referring them on.

This means an extra meeting with the rest of their practice to look at possible alternatives.

This results in longer hours, which is why the PCT is paying for their time as it is much cheaper in the long run.

Dr Godlee said: "Last week we discussed 27 potential referrals and we managed to save six of them where we could deal with things in a different way.

'Quality care'

"It also means patients don't have to go to hospital unless they need to - they prefer to be managed within the PCT."

"That's not to say patients who need to be seen by a specialist will not be - of course they will," the Wantage GP added.

Andrea Young, chief executive of Oxfordshire PCT said: "This increase in activity has resulted in unexpected financial pressures on the local health system.

"As part of this work, we are asking GPs to introduce systems to review their practice referrals.

"We recognise that to do this a significant amount of clinical time and effort is required.

"Therefore we are offering GPs some extra payment to enable practices to staff and resource this process effectively."

The scheme's progress will be reviewed at the end of March.

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