‘Crude, expensive and dangerous’ – scrap referral management centres

Striking junior doctors say that the NHS is everyone’s fight
Striking junior doctors say that the NHS is everyone’s fight

‘CRUDE, expensive and dangerous’ warned doctors yesterday, describing the privately run ‘Referral Management Centres’.

They further warned that the Referral Management Centres act as a ‘block between the GPs and patient treatment,’ putting patients lives at risk and demanded they are scrapped. The danger is that diagnoses will be delayed, missed or dismissed with devastating consequences for the patient, doctors warned.

All but 12 of the 209 Clinical Commissioning Groups (CCGs) in England responded to a Freedom of Information (FoI) request. Sixty-one of them said they used some form of Referral Management Centre, so almost a third.

Since 2005 there has been a ten-fold increase in the use of referral centres. These centres were introduced in 2003 and were designed to cut NHS spending by limiting ‘unnecessary referrals’ to hospital.

Patients, whose GPs are worried that they may have cancer, rather than being referred to a specialist are being blocked by Referral Management Centres. Dr Chaand Nagpaul, from doctors union the BMA, said: ‘It’s a blunt instrument which is not sensitive to the needs of the patient and is delaying patient care.

‘It has become totally mechanistic. It’s either administrative or not necessary for the patient. It’s completely unacceptable. Performance seems to be related to blocking referrals rather than patient care.’

MPs in North Durham have complained about a centre which is paid £10 for every referral letter it blocks. In May, Tracy Jefferies had her referral to surgically strip her varicose veins rejected by Devon Referral Support Services.

She said: ‘The swelling never went down and at night I could barely move. There wasn’t a time in the day I wasn’t in pain for it. I was told on the phone I did not meet the criteria to get treatment on the NHS. I was gobsmacked. I had to borrow money from my dad to pay for the treatment privately. So far I’ve spent over £2,000.’

Anna Athow, Deputy Chair London BMA, said: ‘Preventing GPs from referring patients to hospital outpatients is inherently dangerous. It is well known that in the London area, a very high proportion of patients with bowel cancer present in A&E departments as emergencies. This is a direct result of impairing the ability of GPs to refer in good time to NHS hospital consultants.

‘NHS England is promoting “demand management” first to save money on hospital referrals, and second to promote “patient choice,” by diverting patients for investigations and treatment into the private sector. It is a national scandal and can only be stopped when the entire privatisation plans for the NHS, contained within the Five Year Forward View programme are scrapped.’

Keep Our NHS Public (KONP) said: ‘A private path to an early grave? This “dead pool” money must stop. Referral Management Centres are privately commissioned, receive payments for every cancellation they authorise. This is tantamount to incentivising delay and puts safety at risk.

‘Far from making the NHS more efficient and “cutting down on waste,” such payments which reward cancellation are like running a “dead pool,” seeking to gain financially from the grave misfortune of others. It has no place in a publicly run health service and should be banned immediately.’