Divided we fall. The “Mutual” of health care gets another body blow… Explicit division into a two tier system begins..

GPs are told to refer to private sector in a bid to cut local trusts’s waiting times.

Divided we fall. The “Mutual” of health care gets another body blow… Explicit division into a two tier system begins.. It is not the job of the Commissioning Groups to consider the ideology, rather to balance the books. It will be interesting to see if conservative politicians address this explicit rationing by wealth.

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Exclusive GPs in Hertfordshire have been told to not refer patients to the local NHS trust but instead refer to alternatives providers, including ‘independent sector providers’.

NHS Herts Valley CCG has told GPs to refrain from referring patients to West Hertfordshire NHS Trust (WHHT) for non-urgent appointments wherever possible, and has put a bar on all referrals for certain specialties, including cardiology, ENT, urology, pain, and general surgery.

Instead GPs have been told to refer patients to alternative hospitals, including local private providers, while the Trust is in the process transferring existing referrals to the private hospitals. The referrals will be funded by the NHS.

This is in a bid to cut waiting times at the trust, which has failed to meet national 18-week referral to treatment targets.

It follows the proposal by NHS St Helens CCG to defer all non-urgent referrals over a four-month period this winter – from which it later backtracked

NHS Herts Valley CCG has asked GPs ‘wherever possible to refer to alternative NHS and independent sector providers’ in a letter sent earlier this month headed ‘urgent for action’

In addition they have been told not to refer any patients at all to eight specific specialties ‘for the next three months in the first instance’.

The letter explains that WHHT is failing to meet the 18-week referral to treatment standard ‘in a number of specialties’ and that the hospital is ‘performing at a rate of 89% against a target of 92%’.

The eight specialties with a complete bar on referrals are cardiology, ENT, urology, pain, general surgery, ophthalmology, trauma and orthopaedics and rheumatology.

In addition, the letter says that WHHT is ‘seeking additional capacity from the independent sector and transferring patients for treatment’.

The CCG adds that it is also reviewing referral thresholds ‘as we need to ensure these remain within the overall funds available to the CCG’.

NHS Herts Valley CCG told Pulse in a statement: ‘Currently WHHT is experiencing some pressures on its ability to deliver the required waiting time of 18 weeks from referral to treatment in a number of specialities.

‘We have advised GPs that they can suggest alternative non-urgent referrals to their patients away from WHHT for a short period of time (initially three months) to allow the trust to clear the backlog of patients waiting.’

Pulse reported last week that NHS St Helens CCG proposed to suspend all non-urgent GP referrals for four months over the winter in a bid to tackle a £12.5 million funding gap for the year.

It later backed down, after GPs has said the move was ‘unacceptable’ and warned it would lead to missed diagnoses and cost the health system more in the long run.

Another cost-cutting scheme in Devon saw GPs having to devise management plans and treatment for one-third of all patients they had referred to urology specialists.

Last year, NHS Redditch and Bromsgrove CCG asked GPs to not refer to a local acute trust for at least three months to allow the hospital to clear up its backlog of operations.

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This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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