GPs should refer patients as normal during COVID-19 outbreak, says NHS England

GPs should continue to refer patients to secondary care using the usual pathways during the coronavirus outbreak, even though trusts have suspended elective care, NHS England has said.

(Photo: Stephen Barnes/Getty Images)
(Photo: Stephen Barnes/Getty Images)

New guidance, due to be published next week, will instruct secondary care to accept and hold clinical responsibility for any referrals GPs make during the pandemic.

Trusts across England suspended all non-urgent elective activity from 15 April for at least three months, however many trusts began suspending elective procedures from the second half of March.

A primary care bulletin from NHS England medical director for primary care Dr Nikki Kanani and director for primary care strategy Ed Waller on Thursday said: 'In the current context it is important that clear, consistent processes exist to ensure safe handling of emergent, urgent and routine referrals from primary care.'

It said GPs should continue to refer patients using usual pathways 'and to base judgements around urgency of need on usual clinical thresholds'.

GP referrals rejected

During a webinar on Thursday evening, Dr Kanani acknowledged that GPs in some areas were having referrals 'bounced back, or being told they can't'. She said the new guidance would provide 'a clearer direction to the system'.

'What that means in practice is that you will continue to refer,' Dr Kanani said. 'We will all want to do be able to that – we will all still see and speak to patients who need to be referred and we would like you to continue doing that and asking specifically for secondary care to accept those referrals, to then prioritise and to offer consultations virtually or face-to-face if that is appropriate to those patients.

'They might also then offer advice and guidance because they might not be able to bring somebody in, but we really want that system to be working together recognising the whole system is under pressure.'

The primary care bulletin said that when referring, GPs should take account of the need for remote consultations and likely delays due to the suspension of routine elective activity. Patients should be told about the delays when they are referred, the bulletin added.

It also advised GPs to use specialist advice and guidance where possible to help support the management of patients in primary care, including for patients waiting to be seen by hospitals.

The bulletin added: 'Colleagues should work collaboratively across primary and secondary care to ensure this advice and guidance is provided in a timely fashion to ensure safe care is delivered, taking into account the exceptional pressures which exist across the whole system.

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