Exclusive - PCT bid to cut costs endangers patients

PCTs could be putting patients at risk by pressuring practices to cut their use of diagnostic tests, GP leaders have warned.

Dr Nagpaul said it was dangerous for PCTs to reduce scan referrals (Photograph: SPL)
Dr Nagpaul said it was dangerous for PCTs to reduce scan referrals (Photograph: SPL)

GPC negotiator Dr Chaand Nagpaul said PCTs have been giving individual practices 'tacit' suggestions to reduce high use of diagnostic scans, in order to cut referral costs.

Dr Nagpaul warned GPs not to forego patient care to hit referral management targets.

The comments echoed concerns from RCGP chairwoman Dr Clare Gerada (GPOnline, 10 February). Last month, she told a House of Commons health select committee enquiry on commissioning that putting too much pressure on GPs to reduce referrals could delay diagnoses.

Dr Nagpaul said it was a 'dangerous tactic' for PCTs to try to reduce the absolute number of referrals for scans. He backed reducing inappropriate referrals but said it would be more helpful for PCTs to encourage good practice than to demand outright reductions.

GPs will be incentivised to audit and improve their process of referrals to secondary care under new indicators in 2011/12 QOF.

But the GPC insists the move will not pay GPs to make cuts.

Dr Nagpaul added that pushing for outright cuts could discriminate against practices in areas with high deprivation.

Emerging consortia must prevent this current system of 'crude judgment' and develop better ways to track referral rates, Dr Nagpaul said.

Sarah Woolnough, director of policy at Cancer Research UK, said the reports were 'very worrying'. 'Diagnosing cancer as early as possible is critical to help improve survival and GPs should not be discouraged from actively investigating worrying symptoms,' she said.

The DoH will set aside part of a £750 million budget for its 'Improving outcomes' cancer strategy to fund improved GP access to diagnostic tests for cancer.

NHS Scotland wants to cut variation in GP referrals as part of a plan to generate £300 million in efficiency savings in 2011/12 (GP, 25 February).

Stephen Robinson

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