Private companies are screening GP referrals

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PRIVATE companies are acting as a barrier between GPs and the NHS, putting patients’ lives at risk.

Millions of pounds are being spent on privately-run schemes to ‘screen’ and prevent patients from being referred by GPs to specialist services, it emerged yesterday. Doctors warn that the danger is that diagnoses will be delayed or missed or dismissed with devastating consequences for the patient.

The British Medical Journal revealed yesterday that two in five NHS Clinical Commissioning Groups (CCGs) use a referral management system, a third of them run by private companies. The revelation follows a recent BMJ report on North Durham CCG’s decision to commission private company ‘About Health’ to screen GP referrals to reduce ‘unnecessary’ outpatient activity and save money.

The BMJ findings show 93 referral management schemes in operation across 72 CCGs, with 32% run by private companies. Richard Vautrey, deputy chair of the BMA’s GP committee, said: ‘CCGs are leaping at these schemes without any clear evidence of benefit and that they’re just hopeful that it might reduce their costs. It is a very, very short-term approach to healthcare management.’

The lack of evidence provided to The BMJ on savings was a particularly concerning finding, he said: ‘As public bodies, there should be an expectation on every CCG to account for what it’s doing.’ However, leading BMA member Anna Athow responded: ‘It is shocking to hear that CCGs are spending millions of pounds of NHS money on management referral schemes.

‘The aim of these schemes is to vet the GPs’ referral of a patient to a hospital outpatient clinic, in order to cut down and save money on the number of consultant-led outpatient appointments.

‘The BMJ questions whether these schemes are value for money and given that 32% of the schemes surveyed were run by private companies, someone is definitely making a profit out of them, but the much bigger question is: what is the effect on patient care?

‘The GP knows the patient, their history and examination. He is medically qualified and experienced and the best person to decide whether the patient should be seen in the hospital outpatient clinic.

‘With only the GP letter to look at, private company second-guessers, or even distant clinical experts who don’t know the patient, should not be interfering with GP-to-consultant referrals. The danger is that serious diagnoses will be delayed or missed. It is this that the BMA should be jumping up and down about, not just the possible waste of money.’

Meanwhile, staff at a private ambulance firm had only an hour’s training to drive under blue lights, it emerged yesterday. The Private Ambulance Service (PAS) in Basildon, Essex, provides emergency cover for the East of England Ambulance Service. PAS blue-light driver training has been outsourced since January 2016.

In February last year, Gary Page, 54, died at home in Laindon, Essex, hours after being seen by a PAS crew working for the East of England Ambulance Service. He had had a heart attack but was told he had a pulled muscle or indigestion. A coroner at his inquest in September said he had been the victim of serious failings.

• Busy A&E departments are forcing patients to wait for hours in ambulances outside hospitals, with over 6,000 patients left to wait each week in ambulances in London alone. Taj Hassan, President of the Royal College of Emergency Medicine, warned yesterday that A&E departments are ‘buckling under pressure’, with staff ‘working at the very limits of their abilities’, adding that the four-hour target for seeing patients in A&E is ‘deteriorating at an alarming rate’.