Cash strapped CCGs ask GPs not to refer some patients to hospital
BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5484 (Published 09 September 2019) Cite this as: BMJ 2019;366:l5484
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I think most would agree that no health system can work without some boundaries but when those boundaries are counter productive they need to be challenged.
Our Government seems to dip in then out of 'austerity' for no clear economic reasons. At the same time over £100m has been given to ferry and train companies in case of a no deal Brexit to plan to provide extra services - services that they will be charging a premium rate for anyway with a £56m penalty if those contracts are cancelled. So money is available should our government chooses to spend it.
Why don't CCGs start acting for the interests of their populations by publicly and loudly stating that they are underfunded for the needs of their population.
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So, when a GP decides that a patient needs to be seen he or she needs to think twice and if something goes wrong has to carry the can?? I don’t think so!!!
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Four points:
1. When the patient’s health deteriorates as a result of the GP’s refusal to refer for treatment, should the patient sue the GP (who might then try to pass the buck to the CCG?) ?
2. When the CCG makes such decisions, is it not over-riding clinical judgement? And the GPs who are members of the CCG: are they not interfering with the ability of the individual clinicians to treat the patient appropriately? How does the General Medical Council view this obstruction of medical treatment by registered medical practitioners? I would remind the readers that GPs choose to sit on these Groups. They are not legally obliged to do so.
3. Has the British Medical Association or the Royal College of General Practitioners studied the antics of the CCGs? Have they decided that the CCGs are of any use? If so, could someone please enumerate the advantages?
4. The members of the CCGs are rationing clerks. Are they proud?
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This is back to the early 90s when practices held commissioning funds. Some would only refer those patients who were literally dying. As a consequence patients who were off work with treatable conditions, such as arthritis of the hip or cataracts, were denied surgery at a significant cost to themselves, their families, employers and,ultimately the state. Delaying surgery meant that later interventions were more expensive, required more rehabilitation, and were less likely to be effective.
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Re: Cash strapped CCGs ask GPs not to refer some patients to hospital. My response to Dr Sharvill
Dear Dr Sharvill
Cash strapped CCGs.
I ask how do the CCGs know the clinical need of a particular patient.
I ask why do the CCGs in different parts of the country set up different boundaries and different criteria to permit patient referral.
I ask, in what way are the CCG-determined referral patterns better than the simple open access referral system which existed in the 1960s. At that time, assuming the patient lived in Deal, Kent, and the GP felt he needed hip replacement, the GP could refer him to the nearest hip centre, or if, for example, his relatives lived in Edinburgh, he could be referred to the Royal Infirmary at Edinburgh, or, if friends and relatives were in Wales, he could be referred to Cardiff.
As for money problems - I recall that in the 1960s, the Govt was shamed into starting NHS Kidney dialysis after Dr Sheldon.
There was a report in the BMJ that many CCGs were using private firms to screen referrals made by the GPs.
Is that not an insult to the GPs, and a waste of money?
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