NHS North Durham CCG is trying to eliminate unnecessary outpatient appointments. This has prompted the CCG to bring in a medical contractor, which will have the authority to cancel GP referrals.
The GPs will have to first get permission from About Health, which is a referral management service, for outpatient appointments. The medical contractor will have the powers to overrule an appointment if it believes that it is not required.
NHS consultants and GPSIs working for About Health will review referral letters. This review will not be free; GPs would have to pay £10 for each review. About Health will deploy a rapid specialist opinion service that will take approximately three working days to reject or approval a GP referral. If the referral is rejected, GPs can appeal the decision taken by the healthcare contractor. The appeal will be reviewed by an independent consultant and will be final.
The CCG stated that this decision was being taken to reduce the burden of referrals, which can cost about £150 per referral. The CCG went on to explain that outpatient appointments should be the last resort when all other healthcare solutions have been exhausted.
At the moment, About Health will be focusing on six main areas of health: gastroenterology, cardiology, ophthalmology, dermatology, gynaecology and ENT. Based on the guidelines provided by the CCG, About Health will decide whether it is necessary for a patient to be referred to a specialist in one of these fields. It is believed that more specialties will be added to this list in the near future.
However, GPs are not happy with the decision taken by the CCG. They have stated that this decision makes it clear that the NHS does not understand the role that general practice plays in healthcare.
BMA GP Clinical Lead Dr. Andrew Green stated that the move taken by the NHS was undermining the professionalism of general practitioners, a profession that is already struggling to recruit new GPs.