GPs offered cash incentives to not refer patients

Pulse has reported that GPs in five areas of England are being offered cash payments not to refer patients to hospital.

The controversial ‘profit share’ agreements see GPs paid up to half the savings if they refrain from referring their patients to hospital. The ‘cash for Cuts’ investigation follows the RCGP raising concerns about the effect of referral restrictions on patient care. With freedom of information responses from 181 CCGs, Pulse claims that a quarter are offering some kind of financial incentive designed to cut referrals to specialists.

The five ‘profit sharing’ schemes, include: NHS Coastal West Sussex CCG offering groups of GP practices 50 per cent of the savings on any reduction in elective activity from the previous year; GP federations in West Leicestershire receiving 30 per cent of savings made on first elective referrals; NHS Vale of York CCG offering GP practices a ‘gain/share’ arrangement for dermatology referrals and ‘a proportion of any savings achieved’; NHS Enfield CCG saying 50 per cent of any cost reduction for GP-referred outpatient attendance ‘will be shared with the locality’; and NHS Wolverhampton CCG considering a profit-sharing scheme.

Helen Stokes-Lampard, chair of the Royal College of GPs, said: "Reviewing referrals is an important part of general practice, and a constructive part of professional development for GPs, but it must be proportionate, safe, and put the patient at the heart of the decision. Our report, launched earlier this week, highlighted that GPs need support to ensure that referrals are appropriate – not ethically-questionable initiatives that prioritise cost-savings over patient care. Cash incentives based on how many referrals GPs make have no place in the NHS, and frankly, it is insulting to suggest otherwise."