Should GPs be paid to reduce unnecessary referrals?

Doctors decisions are inevitably affected by financial incentives, there would be not point in the incentive otherwise and other responses give demonstration that this is the case. what is important is to give the right incentives, rather than paying GP for fewer referrals, pay GP for high quality referrals that had postive outcomes, including patient ( and GP ) reassurance. However as with all targets the easier target and measureable outcomes are selected which is what appears to be happening here, it is easy to count numbers of referrals more difficult to measure quality. Improving community services including intermediate clinics are an effective way to provide better care for patients and lower cost and Cumbria is part of the Vanguard Better CAre Together in order to do just that. As doctors we are often have the dilemma of some financial incentive in what care the patient chooses to have, whether it be their child immunised, or take a statin or have an private operation, what is important to drive the behaviour to provide high quality care. I think if doctors are being paid not to provide something for their patient then this is indeed a case for the GMC to investigate, but as is so often the case the GMC backs off investigating such issues. I agree with other responders, unecessary referrals is unecessary to the person reviewing the referral, not the GP who makes the referral, and therefore does not acutally exist. If the referral is not within guidelines, then this should be described as such, not as unecessary, as there may be other factors outwith guidelines for the referral.