Editorial - Hospitals must do their bit to cut referral costs

Earlier this year GP ran a survey looking at GPs' workload. Unsurprisingly it found that GPs were working harder than ever before.

One issue that was raised more frequently than any other was referrals. Complex referral forms and protocols, extra work-up of patients before they are even 'allowed' to be referred and referrals being inappropriately 'bounced' to community clinics were all creating more work.

But two issues: GPs having to see and re-refer patients who fail to attend their initial outpatient appointment, and local 'bans' on consultant-to-consultant referrals, were mentioned most frequently.

This week's front page uncovers the scale of this problem and, where it happens, it places a huge amount of extra work on general practice, none of which is funded.

GPs accept the need to refer appropriately and scrutiny of referrals has been part of general practice for some years. But to ensure effective referrals, which will allow the NHS to make the best use of its resources, both sides of the system (referrer and provider) must be looked at. Too often the focus is on the referrer, but providers play a crucial part.

The problems GP highlights this week create inefficiencies in the system. Surely it is quicker and cheaper for the outpatient clinic to contact non-attending patients rather than them taking up another GP appointment? Why should GPs be expected to absorb this extra work? Barring consultant-to-consultant referrals not only creates more work, it is annoying for patients and potentially leads to delays.

As CCGs take control of budgets they will inevitably see referrals as an area where they can control costs. The challenge will be managing referrals without placing undue pressure, and extra unfunded work, on general practice. Hospitals must take on their share of this work rather than expecting GPs to pick up the pieces.

The key to this will be better integration, improved communication and a more joined-up approach between primary and secondary care.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

Close up of hand holding sample tube with 'Omicron' handwritten on side

Government urged to 'free up' GP practices and expand steps to control Omicron

GPs have called for immediate action such as suspension of QOF to allow practices...

(Photo: Mike Kemp/Getty Images)

Coronavirus: Key guidance GPs need to know about COVID-19

GPonline provides an overview of the key guidance relating to coronavirus, including...

External wall of GP surgery with wording 'medical centre'

‘Utterly toxic’: GPs speak out over abuse and physical attacks on practice teams

GPs have condemned a rise in verbal and physical attacks on practice staff - warning...

Artist's image of a spiked virus

Javid warns of 'substantial risk' from new COVID-19 variant

The highly mutated COVID-19 variant B.1.1.529 'may pose a significant risk to public...

Desk with lettering 'LMC conference'

LMCs reject 'outdated' GMS contract and demand move to item of service payments

LMCs have voted to scrap the 'outdated and inadequate' GMS contract and to replace...

GPs at an LMC conference waving green voting cards in the air

LMCs demand ringfence on enhanced services cash and clear GP representation in ICSs

LMCs have called for a ringfence on enhanced services funding, along with a guarantee...