Will my GP's hospital referral be accepted



21:07 GMT, 31 March 2012

There was an outcry last month when it was revealed that some NHS Trusts are denying operations and procedures to smokers or those who are obese.

But this is really only the tip of the iceberg as GPs, tightening their budgets, now practise what is known as referral management, in an effort to streamline and reduce costly, unnecessary referrals.

Here is what you need to know, should your request to see a specialist be turned down.

GPs are tightening their budgets in and effort to streamline and reduce costly, unnecessary referrals

GPs are tightening their budgets in and effort to streamline and reduce costly, unnecessary referrals

Why are hospital referrals targeted for budget cuts

GPs make more than nine million referrals a year leading to an expenditure of 15billion. Some GPs are referring for conditions that can be treated perfectly well by a GP in primary care (such as asthma) and do not need specialist input.

We are often under pressure to ‘do something’ which may be making a referral, even if a specialist will not alter the management of the condition. Many referrals are made for reassurance and a specialist opinion rather than treatment.

How does this affect me as a patient

You can no longer ask a GP for an appointment to see a specialist, unless your doctor feels it will actually optimise the management of your condition.

There are now lists of treatments that are not offered on the NHS as they are deemed costly and unnecessary, ranging from varicose vein surgery to removal of benign moles, so all these referrals are denied.

Perhaps most surprisingly, even if your GP does sanction a referral, it may be rejected by the referral management team who are scrutinising every case. This means that rather than being offered a letter for an appointment, you will receive a letter saying your appointment has been rejected.

Can managers, rather than doctors, be trusted to dictate who gets referred

Actually, the referral management teams are doctors, and all the criteria for referrals have been set by clinicians.

The aim is not to reduce numbers of referrals to a government target figure.

The idea is that referrals are made correctly to the right specialist and only if it is beneficial to the patient.

What can I do if my referral has been rejected

Speak to your GP. Check your referral was sent to the right team – often they are rejected because they have been made to the wrong specialist for your condition.

Find what other options are available. There may be a community clinic for your problem (common now in dermatology) run by specialist nurses or ‘special interest’ GPs.

Make sure the GP has offered you all the treatment available from general practice – some GPs are too quick to refer for treatment that they are perfectly capable of offering you themselves.