Referrals between consultants: Consultant referrals are funded

doi:10.1136/bmj.332.7539.490-b

BMJ 2006;332:490 (25 February), doi:10.1136/bmj.332.7539.490-b

Letter

Referrals between consultants

Consultant referrals are funded

The first 150 words of the full text of this article appear below.

EDITOR—Goodman correctly says that consultant to consultantreferrals are not part of the monitoring of waiting time standardsfor trusts and therefore may be given less priority by trustmanagers.¹ However, he is mistaken in his assertion that consultantto consultant referrals are not funded and that this may alsoinfluence how managers behave.

Under payment by results, all outpatient attendances are chargedat tariff. First outpatient appointments have a higher tariffthan follow-up attendances, but the source of the referral isnot relevant. Primary care trusts therefore fund trusts forconsultant to consultant referrals in exactly the same way asthey do for general practitioners' referrals. It is this issuethat is driving some primary care trusts to try to get a bettergrip on referrals between consultants.

There will always be perverse incentives in a bureaucracy ascomplex as the NHS, but it is important to . . . [Full text of this article]

Tim E P Davies, director of public health

South Worcestershire Primary Care Trust, Worcester WR4 9RW tep.davies@btinternet.com