PCT policy stops GPs giving choice

GPs' attempts to offer patients choice have been thwarted by their PCT's referral policies and closed consultant lists.

Orthopaedic surgeons at Worcestershire Royal Hospital have had closed lists since July because they do not have enough free slots to meet the government’s 13-week referral target.  

Local GPs have been left unable to offer choice to patients seeking orthopaedic treatment because Worcestershire PCT will not commission services that exceed national waiting time targets. It is also routing GP referrals through a referral manage- ment unit.  

Worcester GP Dr Bob Ingles said: ‘I am sure this was not what the government intended.’  

GPs are to meet local MP Mike Foster to protest.  

John Rostill, chief executive of Worcestershire Acute Hospitals NHS Trust, acknowledged GPs’ frustration: ‘The system leads to a great deal of frustration for GPs and patients trying to make the best use of this government initiative.’  

He said it was impossible to accommodate all referrals to a popular, named consultant within 13 weeks unless trade-offs with a faster referral to another consultant were accepted ‘without our being penalised under the waiting time initiative’.  

But he said that only two out of 16 consultants had closed lists.  

Mr Rostill promised GPs he would ‘take personal responsibility to make sure capacity was increased’ by mid-November.    

Dr Ingles said patients routed through Choose and Book go to the referral management unit and that there was concern that they were being denied choice.  

He could not say how many patients had been denied choice but said there were enough for the LMC to be concerned.  

‘These referral type problems seem to be becoming more prevalent nationally,’ he said.  

Worcestershire PCT has a contract with an independent-sector treatment centre (ISTC) at Kidderminster.  

‘There is some pressure to use the ISTC,’ Dr Ingles said. ‘They have a contract and if they do not achieve a certain level of activity, they will be wasting money.’  

A Worcestershire PCT spokeswoman admitted it was policy not to commission services that would exceed the national 13-week target.  

‘The PCT is working with the acute trust to improve capacity planning and modernisation of processes to ensure that GPs can book patients into all specialties within 13 weeks,’ she said.  

‘Worcestershire PCT and Worcestershire Acute Hospitals NHS Trust are working on an access policy which advocates the use of pooled referrals wherever possible.’ 

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