05.01.17
CCGs paying millions to firms that delay GP referrals
CCGs are paying millions to private organisations that can stop patients being referred to hospital by their GPs, an investigation has found.
‘Referral management centres’ are being used by some CCGs to scrutinise GP referrals of patients to hospitals, with some criticising that they risk delays in diagnosis.
Following Freedom of Information requests sent by the British Medical Journal (BMJ) to all 211 CCGs, 72 (39% of respondents) said they commissioned some form of referral management scheme, with some CCGs having more than one.
Dr Richard Vautrey, deputy chairman of the BMA’s GPs committee, told the BMJ: “[CCGs] are leaping at these schemes without any clear evidence of benefit. They are just hopeful that it might reduce their costs.
“It is a very short-term approach to healthcare management. We need to see much more evaluation … and not just keep making the same mistakes year after year. As public bodies, there should be an expectation on every CCG to account for what it is doing.”
Almost a third of the referral management schemes the CCGs admitted commissioning are offered by private companies, with a further 29% provided in-house and 11% by local trusts.
Most CCGs were unable to provide evidence that schemes saved them money, with 74% failing to supply figures while only 14% could show that using the scheme offered a cost benefit.
Overall, CCGs admitted to spending at least £57m on referral management schemes since April 2013.
Some CCGs did not collect data on savings, saying that their scheme was designed not to save money but to improve the quality of referrals made by doctors.
Graham Jackson, co-chair of NHS Clinical Commissioners, said referral management was just one way of managing demand, saying that they are “more than a redirection service” in many cases.
Despite his criticisms, Vautrey acknowledged that some referral management schemes do help GPs by giving them rapid access to advice from local specialists.