Failure to restore safe referral system leaves GPs facing unfair risk, warns BMA

GPs urgently need a safe referral system to support patients who require hospital treatment as practice workload returns to pre-COVID levels, the BMA has warned.

BMA GP committee chair Dr Richard Vautrey (Photo: BMA)
BMA GP committee chair Dr Richard Vautrey (Photo: BMA)

Hospitals were given permission to suspend routine procedures from mid-April to focus on expanding capacity to cope with the pandemic.

Trusts have since been told to begin restoring non-COVID-19 services - including routine procedures where possible - as part of the NHS' second-phase response to the outbreak. GPs have also been told that they should refer patients to hospital as normal, with hospitals expected to process and accept clinical responsibility for referrals even if they are currently unable to offer treatment. 

GPonline has previously reported on GP practices coming under increasing pressure, with patient demand rising while some hospitals continue to refuse referrals.

BMA GP committee chair Dr Richard Vautrey said this week that blocked referrals 'continues to be a concern' for GPs.

GP referrals blocked

The Leeds GP revealed some areas could only make urgent referrals as he called for trusts to create a safe referral system to reduce patient anxiety and ease workload for GPs.

He said: ‘It's very frustrating both for practices and for patients. GPs make a referral as we think is appropriate. But then if that's rejected then that can leave the patient coming back to us and asking for letters to try and expedite the process.

‘[This] adds more administration work for GPs, it causes anxiety for the patient - not really knowing when they're going to be seen - and adds more work and concern for everyone involved.’

He added: ‘The more we can reduce that by having a safe referral system that enables referrals to be held without necessarily patients being seen in the way that they might have been seen previously, I think that would help everyone.’

Delayed cancer checks

A GPonline poll revealed this month that 30% of GPs said they have had an urgent referral rejected during the pandemic, while it found some patients referred on the urgent two-week cancer pathway had been waiting more than a month to be offered an appointment.

Polling carried out for the NHS last month suggested that millions of patients were not calling their GP practice because they did not want to add to workload during the COVID-19 pandemic - although practices are now reporting workload climbing back to where it was if not higher.

Dr Vautrey said rejected hospital referrals were leaving GPs in a ‘difficult position’ as practices started to see more patients.

He said: ‘GPs have a professional responsibility to refer patients when we feel it's appropriate to do so. But if the systems are not in place to enable that responsibility to be fulfilled, it leaves practices carrying a degree of risk that may be inappropriate and leaves patients without access to the services that they really need.’

A GPonline poll found that 77% of GPs are concerned that delays to operations and treatments for non-COVID-19 issues would result in patients coming to harm.

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