Re: Should GPs be paid to reduce unnecessary referrals?
I'm sure all GPs would hope to make appropriate referrals that are in the best interests of the patient. With an appropriate transfer of resources even, some of these patients could be better managed in the community. Introducing a financial incentive into the referral equation is wrong no matter in what guise. The trust that exists between doctor and patient will be irrevocably eroded and the doctor-patient relationship destroyed. GPs as usual are often between a rock and a hard place.
Expectations of the NHS by patients have been fuelled by successive governments over the last decade. There can be extreme pressure by patients to refer to secondary care. They are wise that they can wield the friends and family test and put a nasty comment on NHS choices.
Access by GPs to different treatment strategies will vary widely across the NHS. Rather than pay GPs to reduce referrals, use that money to improve community services. That may involve investing in dietetic services, cutting waiting times for physiotherapy and thereby avoiding joint replacement surgery, and increasing consultant clinics in the community. This question highlights the need for the movement of resources from hospitals to primary care, phase out the secondary/primary care interface, and then the whole issue becomes irrelevant.
Rapid Response:
Re: Should GPs be paid to reduce unnecessary referrals?
I'm sure all GPs would hope to make appropriate referrals that are in the best interests of the patient. With an appropriate transfer of resources even, some of these patients could be better managed in the community. Introducing a financial incentive into the referral equation is wrong no matter in what guise. The trust that exists between doctor and patient will be irrevocably eroded and the doctor-patient relationship destroyed. GPs as usual are often between a rock and a hard place.
Expectations of the NHS by patients have been fuelled by successive governments over the last decade. There can be extreme pressure by patients to refer to secondary care. They are wise that they can wield the friends and family test and put a nasty comment on NHS choices.
Access by GPs to different treatment strategies will vary widely across the NHS. Rather than pay GPs to reduce referrals, use that money to improve community services. That may involve investing in dietetic services, cutting waiting times for physiotherapy and thereby avoiding joint replacement surgery, and increasing consultant clinics in the community. This question highlights the need for the movement of resources from hospitals to primary care, phase out the secondary/primary care interface, and then the whole issue becomes irrelevant.
Competing interests: No competing interests