With all the talk of change and proposed changes to the NHS – including amendments to its structure and access – I am afraid I will be writing regularly on this subject.
I think it is important that the issues are highlighted though, and hopefully you will be able to go to your local NHS, groups, and anyone that will listen, to check the facts out and see what is happening in your area.
Seeing as money is so short, I was horrified to read that your local CCG is paying millions of pounds to private firms to scrutinise patient referrals to specialist hospitals services by family GPs. So even if your GP feels you should be referred to a specialist hospital – this private firm may block the request.
They are even screening conditions such as cardiology, gynaecology and gastroenterology. So where does this leave the GP? Not in a very good place! They have to provide you with some sort of explanation as to why you can’t be referred to the specialist hospital and try and convince you that your local hospital (which does not have the equipment or expertise) is the right choice for you!!! Also is this really demonstrating the CCG’s complete trust in the expertise of the GP? If I was a GP I think I would feel slightly insulted…
So, is there any logic to the scheme? My first reaction is no – your GP who knows you, has examined you etc. is the right person to determine the appropriate treatment and make the referral. Not some grey suited bureaucrat with little or no medical knowledge who bases the whole decision on a short referral letter.
As treatment rationing has also come in, how likely is it that they will take one look at your date of birth and reject you without reading any further? Also if the referral has to go through an added layer of bureaucracy, it will delay possible confirmation of diagnosis and when specialist treatment is needed we all know that sooner is better than later. What if the bureaucrat does not like the GP? Will they be impartial?
Another reason is one you would expect: it saves money. But does it? Nearly 70% of CCGs with schemes combined have spent at least £57 million since April 2013. That’s a huge amount of money. In fact, most CCGs were unable to provide evidence that the scheme saved money. Only 14% could show that it had saved more money than it had cost to operate and 12% showed that it had saved no cash at all. Three quarters of CCGs were unable to produce any data in respect of savings or whether the system was running at a loss.
It would also be interesting to hear about the numbers of referrals which were rejected and see if there any common themes like age as the basis for rejection.
The Deputy Chairman of the British Medical Association’s GPs committee has said that “CCGs are leaping at these schemes without any clear evidence of benefit and that they’re just hopeful that it might reduce their costs”. Again the emphasis appears to be on money – not the good of the patient.
So what do you think? Is it a useful/sensible way to spend money when money is so tight? Why not ask your local CCG how much they are spending on this service. How many referrals have been rejected for specialist treatment? Can you get any information from your local Healthwatch on this matter? Have you been refused specialist treatment? What explanation were you given?
It may make the CCGs stop and think if they become aware that the general public is in the know and is holding them accountable.