“The lack of GP access to secondary care referral pathways is not acceptable”, say doctors from The Doctors’ Association, Doctors for the NHS, GP Survival and 999 Call for the NHS in an open letter to Health Secretary Sajid Javid.
With an ever-increasing strain on primary care, GPs are currently under huge pressure to care for patients who may be waiting for hospital care, such as someone waiting for a joint replacement, and needs medication for pain, or antidepressants when the wait gets too much. In addition, GPs are also picking up the fall out for patients who are having to wait months for physiotherapy and years for assessments for autism and ADHD.
And it is no coincidence that GPs are seeing a huge increase in demand for private referrals; 100% of DAUK members who completed a recent poll believed that requests for private referrals are rising. This is in part due to a large number of referrals being rejected, which leaves patients who can afford to, to pay for private care, and those who can’t, to suffer.
Dr Lizzie Toberty, GP Lead for DAUK, believes even advice and guidance (A&G) is becoming another hurdle to climb, as it appears to be so heavily mandated that GPs are being prevented from referring onwards when required.
She says, “If a GP has decided a referral is necessary, and the situation is outside their competency then they must refer onwards, in line with GMC advice.
Allowing specialists who have not assessed the patient themselves to make the decision whether a referral is justified, is not in keeping with the current emphasis on face-to-face consultations, and risks patient safety.”
The NHS is becoming a two-tier system with lack of referrals and long waiting lists forcing an inequality of medical care within the population. DAUK, Doctors for the NHS, GP Survival and 999 Call for the NHS are calling for the Rt Hon Sajid Javid to urgently review and act on the following points:
- To recognise the impact of these waits on primary care, the need for greater resources and a review into primary care access
- To recognise that when GPs decide to refer patients to other services, rejection of referrals must be the exception. A clear explanation and alternative plan must be given. All rejection letters should be personalised and written directly to the patient, with the GP copied in.
- To halt all moves to mandate A&G
- To continue discussions to reduce waiting times
- And finally, to visit our practices. Please come and understand first-hand the pressures we are under and listen to the solutions. Some things need decades to remedy, but there are quick wins too.
Speaking for Doctors for the NHS, spokesperson Alan Taman said:
“The growing trend in private referrals demonstrates the critical need to invest in the NHS and redress problems over staffing which have been building for years, and will take years to resolve. People should not have to face paying for their own treatment because they will otherwise have to endure waits of months to years – or can no longer get treatment from the NHS because it has been cut. Privatisation is not as a rule happening on a large contractual basis, through competition by private companies for service contracts, at least not yet. It’s happening one worried person at a time, those who can afford to pay or increasingly who can put themselves into debt.”
Steve Carne, Chair of 999 Call for the NHS said: “GPs play such an important role in our healthcare service and the Government should be supporting and celebrating their contribution to the nation’s health. GPs are being subjected to relentless demands with less and less resources. We fully support the call for the Health Secretary to listen and understand the full picture of dangers faced by GPs and the NHS workforce”
For further information:
Doctors’ Association UK – DAUK is a professional association for UK doctors. Run by frontline NHS doctors, DAUK campaigns for patients and the NHS as well as advocating for the medical profession email@example.com
Doctors for the NHS – Doctors for the NHS (DFNHS) was formed in March 2015 by the NHS Consultants’ Association (NHSCA) re-naming itself and asking GPs and medical trainees to join. NHSCA was formed in 1976 and was the oldest continual health-campaigning group with DFNHS’s aims. DFNHS has just over 600 members nationwide, most of whom are senior Consultants or retired senior Consultants. Its membership represents many years of experience in the NHS, often at the highest clinical levels. It has the explicit aim of countering marketisation of the NHS by gathering the already impressive evidence; pointing to the ill effects of commercialisation and systematic under-funding on NHS services and founding principles; and campaigning widely to stop then repair the damage before it is too late and cannot be reversed.
DFNHS’s press contact is Alan Taman:
07870 757 309
GP Survival – A grassroots movement of GPs fighting for the survival of General practice in the U https://www.generalpracticesurvival.com
999 Call for the NHS – 999 Call for the NHS is a national campaign group that supports a network of local campaign groups who are passionate about returning healthcare in England to a fully restored public service with no internal commercial market.
In our 7yr history we have marched from Jarrow to London and fought a 2 year legal battle with NHS England over the introduction of a USA style ‘Integrated Care Provider’ contract. We are currently working with a network of campaigns to scrap the Health&Care Bill which, if passed, will see and end to the ethos of a National Healthcare Service that is available to everyone regardless of ability to pay.