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Medicopolitical Digest

Out of area treatments will replace ECRsNHS could run out of doctorsTax funded health service works wellLabour party starts discussion on health

BMJ 1998; 316 doi: (Published 27 June 1998) Cite this as: BMJ 1998;316:1988

Out of area treatments will replace ECRs

The Department of Health has issued a consultation document that proposes replacing extracontractual referrals (ECRs) with out of area treatments from 1 April 1999.

ECRs are one-off arrangements, which arise when a consultant team or other specialists in a trust provide care which is not covered by a contract with the patient's health authority or other purchaser such as a GP fundholder or commissioning group. From April 1999 primary care groups and NHS trusts will agree service agreements, which will cover all treatments and services, including some services previously covered only by ECRs, such as specialised services.

Other one-off treatments not covered by the specific service agreements will be funded by non-recurrent adjustments to health authority allocations. For example, if a patient away from home was admitted as an emergency he or she would be treated in the nearest hospital. The health authority in which the patient was treated would receive an extra allocation to take account of the costs of the treatment while the patient's home health authority would have its allocation reduced by the same amount.

Individual invoicing will end and prior approval will not be required before …

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