Online exclusive: Third of PCTs increase treatment restrictions

One in three PCTs has this year expanded the list of procedures it will no longer fund, an exclusive GPonline.com investigation has revealed. See our interactive map of PCTs that have made additions to their lists of low-priority procedures.

Dr Nagpaul: ‘The problem with different low-priority thresholds is that they are often drawn up on the basis of local interpretation of evidence'
Dr Nagpaul: ‘The problem with different low-priority thresholds is that they are often drawn up on the basis of local interpretation of evidence'

Some PCTs expect to save over £1m by restricting referrals from GPs, according to responses from 111 PCTs to a Freedom of Information Act request.

35% of PCTs have added procedures to lists of treatments that they no longer fund because they deem them to be non-urgent or of limited clinical value.

Of 72 PCTs who provided detailed information on their plans, 25 had introduced new measures in 2011/12 to restrict GP referrals for interventions that they deemed to be non-urgent or of low clinical value.

Procedures around which PCTs have introduced new thresholds include BMI restrictions for knee and hip replacement operations. Other PCTs have introduced new age limits for the use of grommets thresholds for tonsillectomies or have cut funding of IVF procedures.

PCTs have also introduced new referral management schemes in 2011/12 to filter out inappropriate referrals for low priority treatments.

GPC negotiator Dr Chaand Nagpaul said the GPC was concerned about PCTs applying different low-priority thresholds and rationing access to treatments on the basis of local policies.

He said the government needed to decide on a consistent set of national standards of ‘low priority’ treatments to help remove postcode lotteries in provision.

‘The problem with different low-priority thresholds is that they are often drawn up on the basis of local interpretation of evidence,’ he said. ‘Ultimately that is not fair to patients.’

He added: ‘Patients and the public recognise that with limited resources we need to make the maximum health gains and so there needs to be prioritisation. What is inequitable is that different PCTs are applying different thresholds and criteria.’

The interactive map below shows those PCTs that have made additions to their lists of low-priority procedures.

View PCTs expand low-priority/value treatment lists in a full screen map

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