GP practices offered thousands of pounds to cut cancer referrals, Pulse reports

The investigation revealed that in at least nine CCGs, practices are being rewarded payments for keeping within targets regarding outpatient referrals and follow-ups. Some schemes even validate referrals where there has been a two-week cancer wait, as long as referrals remain within targets.

The General Practitioners Committee (GPC) says such schemes could be perceived as ‘ethically questionable’. According to Pulse, the General Medical Council (GMC) looked into at least one GP operating under the programme to examine whether the practice was contrary to guidance for in doctors in Good Medical Practice.  

The investigation has risen as the health service prepares to implement £22 billion of efficiency savings by 2020, and shows that restrictions are increasing on routine, front-line care.

Dr Robert Morley, chair of the GPS’s contracts and regulations subcommittee, told Pulse that schemes incentivising practices to reduce urgent cancer referrals were ‘extremely concerning’.

He said: “These may, at face value, potentially be ethically questionable and conflict with GMC guidance, on the basis that they might conceivably influence individual management decisions.”

Lambeth GP Professor Clare Gerada, former RCGP chair,  believes the schemes risk ‘interfering with the doctor-patient relationship’. She said: “Once we start incentivising to reduce activity, then it puts a conflict within the consulting room.”

Dr George Ogden, chair of Bolton LMC, said: “The GMC said it would potentially be regarded as an inducement if there was a challenge that GP behaviour changed as a result of the payment. So they were concerned, but didn’t say it was entirely against the guidance.”

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