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Referrals Targets

Q:I have heard through hospital colleagues that our PCT is planning to set tough referrals reduction targets particularly in relation to gynaecology, orthopaedics and ENT. I checked with the LMC but it had heard nothing about this. Should it be consulted, and what pressure can local practice-based commissioning groups exert to keep down these targets in our patients' interests?

A: You are right to be concerned. The PCT may want to decrease the cost of such referrals but you have a professional duty as GPs to ensure patients are referred appropriately.

The PCT could look at designing care pathways, referral triage services or developing alternatives to referrals (such as a GPSI ear microsuction service) but it does need to involve GPs and their representatives though PBC groups and the LMC.

My advice is to approach the PCT and offer to work on options to reduce the number of inappropriate referrals but ensure patients receive the specialist services they need.

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