I’m sorry that this important newsitem from the BMJ is behind a paywall, but I’ll put up the really important bits.
The political imperative is now to get GPs to commission care. One way of ‘saving money’ (if you are interested in short term, shallow, non clinical outcomes) is allegedly to deal with GP referrals via a ‘referral management centre’ the purpose of which is to avoid seeing patients. Or to get patients seen but not by specialist doctors. Or to make is so hard for patients to get seen that they give up trying to do so. (That may sound harsh, but it is the bottom line.)
So I’m worried that one of the first bursts of GP commissing has led not just to a referral management centre, but in partnership with a private non NHS company.
“Concerns have been raised over an early deal signed between one of the new pathfinder GP commissioning consortiums and the private firm UnitedHealth UK. The referral management deal with UnitedHealth UK has been jointly agreed by the NHS Hounslow primary care trust and the London based Great West Commissioning Consortium. The trust said that this was an innovative new service to support GPs in their new role as commissioners and to improve the quality of referrals….”
The thing is, GPs ARE ‘referral management centres’ – except ones with the patient in front of them. If ‘patient choice’ and ‘patient autonomy’ are to mean anything at all, it should mean doctors and patients working together in the consulting room – not referrals farmed out far away to unanswerable administrators.
GPs and private firms involved are taking money for this commissioning task. Does it actually save money anyway? No, say the King’s Fund.
The mainstay of the current referral system is not designed to benefit patients or doctors but targets. I’m disappointed that GPs have chosen to make it worse.