Nav: Home

The BMJ reveals private firms run one-third of CCGs' schemes to screen GP referrals

January 04, 2017

Clinical commissioning groups (CCGs) in England are spending millions of pounds on schemes that screen patient referrals from GPs to specialist services, reveals an investigation by The BMJ today.

Overall, two in five of the CCGs that responded to The BMJ's requests for information use a referral management system of some kind, and a third of the schemes are provided by private companies.

Some of the schemes aim to reduce costs, while others hope to improve the quality of referrals. But almost three quarters of CCGs which responded were unable to provide evidence that showed whether or not their scheme had saved money overall.

The analysis follows The BMJ's recent report on North Durham CCG's decision to commission the private company About Health to screen GP referrals to reduce "unnecessary" outpatient activity and save money.

The move sparked concerns from clinicians and The BMA, which warned that CCGs risked repeating mistakes of predecessor organisations by commissioning schemes of questionable effectiveness.

The BMJ sent freedom of information requests to all 211 CCGs in England. Of 184 CCGs that responded, 72 (39%) said they currently commissioned some form of referral management scheme to help manage outpatient activity in local hospitals.

The findings show:

- 93 referral management schemes in operation across 72 CCGs, with some CCGs operating more than one scheme

- 32% of schemes are run by private companies, 29% in house, 11% by local NHS trusts, 11% by NHS commissioning support units,10% by the voluntary sector, and 7% by local clinicians

- 69% of CCGs with schemes disclosed operating costs. These CCGs combined have spent at least £57m on schemes since April 2013

- Only 14% of CCGs provided figures to show that the scheme had saved more money than it had cost to operate, and 12% showed that their schemes had not saved money overall

- 74% of CCGs with schemes failed to supply figures to show whether money had been saved overall

20% of CCGs commissioned a new scheme since April 2013, and the same proportion are continuing to commission schemes previously set up by primary care trusts

Richard Vautrey, deputy chair of the BMA's GP committee, said "[CCGs] are leaping at these schemes without any clear evidence of benefit and that they're just hopeful that it might reduce their costs. It is a very, very short term approach to healthcare management. We need to see much more evaluation...and not just keep making the same mistakes year after year."

The lack of evidence provided to The BMJ on savings was a particularly concerning finding, he said: "As public bodies, there should be an expectation on every CCG to account for what it's doing."

But some of the schemes that enabled local specialists to provide rapid advice and guidance to GPs "can be very helpful", explained Vautrey.

Graham Jackson, co chair of NHS Clinical Commissioners, the membership organisation which represents CCGs, said referral management was just one mechanism that local groups use to try to manage demand for services.

"In many cases they provide a useful and effective role which is more than a redirection service," he said. "CCGs will balance the cost of commissioning with the benefit they provide to GPs and patients in terms of peer review, education, caseload management and choice."
-end-
Investigation: Referral management schemes: good for whom?
http://www.bmj.com/cgi/doi/10.1136/bmj.i6856

News story: Private firms run a third of CCGs' schemes to screen GP referrals
http://www.bmj.com/cgi/doi/10.1136/bmj.i6855

About BMJ

BMJ is a healthcare knowledge provider that aims to advance healthcare worldwide by sharing knowledge and expertise to improve experiences, outcomes and value. For a full list of BMJ products and services, please visit bmj.com

BMJ

Related Gps Articles:

GPS isn't just for road trips anymore
Precision agriculture technologies can improve efficiency on smaller farms
Small, precise and affordable gyroscope for navigating without GPS
A small, inexpensive and highly accurate gyroscope, developed at the University of Michigan, could help drones and autonomous cars stay on track without a GPS signal.
Australian GPs widely offering placebos, new study finds
Most Australian GPs have used a placebo in practice at least once, with active placebos (active treatments used primarily to generate positive expectations) more commonly used than inert placebos, according to a new study from University of Sydney.
Practice characteristics and job satisfaction among GPs in 11 countries
Organizational and functional features of general practitioner practices in 11 countries were studied in search of underlying reasons for job dissatisfaction.
GPs need training to tackle chronic opioid use
GPs must be better-equipped to support patients to manage the psychological challenge of reducing their opioid use -- according to new research from the University of East Anglia.
The GPS of neurons now better understood with a study published in Neuron
Researchers demonstrated the role that plays the Boc receptor in the the formation of the nervous system.
New continuity of care tracking method for GPs
New research has outlined a simple way to measure continuity of care for GPs, to benefit patients.
Over 40 percent of GPs intend to quit within five years: New survey
A new survey of GPs has revealed that over 40 percent intend to leave general practice within the next five years, an increase of nearly a third since 2014.
A GPS for inside your body
An MIT team has developed a system that can pinpoint the location of ingestible implants inside the body using low-power wireless signals.
New research on why GPs quit patient care
The research aimed to identify factors influencing GPs' decisions about whether or not to remain in direct patient care, and what might help to retain them in the role.
More Gps News and Gps Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.