In early January you may have seen several news stories about the use of referral management centres. Many Clinical Commissioning Groups (CCGs) pay referral management centres to screen GP referrals to hospital specialists. It costs the GP money to refer a patient, so the idea is to save money by avoiding unnecessary referrals.
However, concerns have been raised after a BMJ study found that only a few CCGs (9/72) could show that the process was saving money. There were also concerns that the status of the patient’s recovery hadn’t been considered.
We recently received the following question from a member of the public:
Are GPs in Bucks using a private company for referral management?
We knew that the Aylesbury Vale and Chiltern CCGs were looking at referrals, so we asked them to tell us what they had planned.
Response from the CCGs
They provided us with a statement explaining that they do not “currently implement a referral management process.” However, they did tell us that some GPs practices have been using a “peer review” system. This means that another GP will look at the referral and decide whether it is appropriate. This has reduced the number of referrals made.
The CCGs now plan to undertake an audit of all the referrals that take place from January 2017 to March 2017. The audit will check whether referrals are being made at the right time, in the right way for the right reasons. This audit should not place any additional burden on the GPs or affect the outcome for any patients.
At Healthwatch Bucks, we welcome an approach to referrals which is aimed at reducing anxiety and inconvenience whilst minimising the impact on patients and GPs. We also welcome the focus on referral quality. We’re keen to see what the outcomes of the audit are and whether it results in a proposal for a Bucks-wide referral review system. What is your experience of referrals? Use the search below to find your GP and leave feedback.
Full statement from Aylesbury Vale and Chiltern CCGs
We do not currently implement a referral management process in Bucks. However, we are aware that some of our practices have introduced peer review of elective referrals and seen a reduction in total numbers. We also know that patients can experience a convoluted journey into secondary care, with additional appointments for diagnostics eventually being signposted elsewhere, all adding to their anxiety and inconvenience. Evidence supports the view that if the quality of the referral is high, then the patient experience is better.
We have no measure of the quality and levels of adherence to locally and nationally agreed guidelines and pathways; in order to understand the baseline position we propose to introduce an audit of current referrals during January to March 2017. We plan to audit at the provider recipient part of the pathway, thus not to cause any burden on practices. Within the audit there is no plan to re-direct or reject referrals; this is a true data gathering exercise, so we fully understand referral flow and perceived quality/adherence to pathways. Results would be gathered on an individual GP basis and reported back to practices in April/May 2017. We have asked the LMC [Local Medical Committee] to support us in overseeing the details of the audit parameters and process.