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GPs should offer greater outpatient referral choice – Monitor

GPs must offer patients a greater choice of hospitals and clinics for their first outpatient appointment, health watchdog Monitor says. 

A survey of over 2,700 patients conducted for NHS England and Monitor, which looked at the number of patients being offered a choice by their GPs, found that 60% of patients were not offered a choice when being referred. 

The survey also highlighted that respondents aged 55-64 were the least likely to have been offered a choice with two-thirds (66%) saying that they weren’t. Those aged 35-44 were the most likely to have been offered a choice of where to go, with 42% saying that they were. 

This is despite it being a legal right under the NHS Constitution for patients to choose a hospital or clinic for an outpatient appointment. 

Of those surveyed, just over half (51%) were aware of their legal right and only 53% referred for an outpatient appointment first had a discussion with their GP about where to receive treatment.

Catherine Davies, co-operation and competition director at Monitor, said: “This survey gives us some helpful insight into how patients have experienced choice in England. Some of these results are encouraging, and suggest that many GPs are having helpful conversations with patients about decisions that affect their care. 

“But it also suggests the NHS needs to do more to make sure patients are aware they have a choice and are offered that choice. We will continue in our efforts to make sure this happens, and to help patients feel involved and in control of their healthcare.” 

Monitor and NHS England added that it is important that patients, in consultation with their GPs, are offered their legal right to choose as set out in the NHS Constitution, particularly given the differences between hospitals on such things as waiting times. 

The survey also found that people from black and minority ethnic groups were more likely to have discussed choice with their GP (66% compared with 52% of white patients) although they were less likely to be aware of their legal right beforehand (42% compared with 51% of white patients). 

Ian Dodge, NHS England’s national director for commissioning strategy, said: “While patient choice of first outpatient appointment is a reality for some patients in England, the challenge now is to ensure that everyone enjoys their legal right, for example to choose hospitals or clinics with shorter waiting times, if that’s what they want, in both mental health and physical health services.” 

Chief executive of the NHS Partners Network David Hare told NHE: “Since the NHS Constitution was published five years ago, we know that patients have welcomed their right to more choice over where they receive NHS-funded treatment. These results show that there is still some way to go before it becomes a part of everyday practice, however.” 

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Steve Hawkins   07/08/2014 at 19:43

The real problem is finding out who on Earth one could ask to be referred to. Under the current NHS structure this is almost impossible. What we need is some sort of clearing house where consultants pool their resources, and patients submit their case histories or lists of symptoms, signs and test results. Then those consultants, surgeons or doctors could offer their services to patients they were in a position to help. There should be incentives and rewards for those who were able to clear most people from the waiting lists. The longer a patient has been on the list, the higher should be the rewards. This could go some way towards getting some chronically ill people back to work, and would be a great leap forward over the current situation where the longer someone has been ill, the more they are victimised by both medical profession and politicians who scapegoat them and try to force them off their sickbeds by withdrawal of 'benefits', rather than lift a finger in any real effort to cure them.

Graham Mcphee   07/08/2014 at 20:00

Steve, if only! It may be tricky to set up, but what a brilliant idea.

Sara   08/08/2014 at 11:28

I agree with both comments. I currently work for an IT company that deals with the NHS, but not Primary Care. The feed back we sometimes experience when selling our product to hospitals is that GP's re not always referring the patient correctly nor at the right time, which is having the initial impact on the NHS waiting lists. Until GP's have their own clear pathway and clinical guidance that is much more clear cut - the waiting lists are just going to get longer. As far as the GP is concerned, upon referring the patient (as far as the pathway is concerned) is job done and payment in the bank. It is then up to the over exhausted (not in the lateral sense) Consultants and nurses to deal with patients that are not surgically ready and having to refer back. In the long term the only person that is being overlooked is the patient that is never really consulted regarding their own pathway as there is no real guidance for them. I think the "patience" with GP's is slowly running out with the public and some of tour GP's should be taken back the basics of a Family Dr and what care and following correct clinical protocol is. It should be back to basics and managed from the onset.

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