NHS Pay GP’s To Not Send Patients For Cancer Tests

An investigation has revealed that doctors are being paid millions by the NHS to ration referrals for operations, scans and even cancer tests.

GP’s are being offered the financial incentives in an attempt to reduce the number of patients they send to hospital for a variety of procedures.

While the incentives mainly covers non-urgent referrals, some include cancer tests

The Mail Online reports:

The incentives mostly cover non-urgent referrals for hip and knee replacements, cataract surgery, hearing tests and abdomen scans. But two health trusts have included urgent cancer scans in their schemes, and another two covered heart tests.

Patient groups said the payments were ‘profoundly wrong’, while one MP likened them to ‘bribes’. Doctors’ leaders are also deeply opposed to the schemes, branding them an ‘offensive slur’ on GPs’ medical judgement.

Details of the payments came after figures showed the NHS endured the worst winter crisis in its history, with bed-blocking and waiting times at, or near, record highs. The service is also facing a funding crisis as it struggles to meet the demands of the ageing population and migration.

Reducing the number of patients sent to hospital is one way of cutting costs. Only last month Simon Stevens, the head of NHS England, warned patients to expect longer waits for routine operations so the health service could prioritise cancer care and A&E.

But many Clinical Commissioning Groups have independently drawn up their own cost-saving plans. The Daily Mail found that at one in eight health trusts in England, family doctors are being offered financial incentives to reduce or review their referrals.

Freedom of Information requests were made to all 209 CCGs in England, to find out whether they offer incentives to GPs for cutting referrals. Of the 182 that replied, 15 have schemes which pay doctors money directly for slashing numbers by a certain target.

Another seven offer incentives to doctors who promise to review referrals and ensure they only send patients to hospital where ‘appropriate’. This means 22 CCGs pay GPs extra cash for reducing or reviewing the numbers of patients sent to hospital.
Last year they paid out at least £5.74million – although the true amount is likely to be higher, as a third of CCGs were unable to supply figures. The majority of schemes cover less urgent procedures including hip and knee replacements, cataract surgery, hearing tests and blood tests.

But two CCGs, Cumbria and Greater Huddersfield, specifically target heart operations or scans among the procedures they want GPs to curb.

Another two, North East Lincolnshire and North Hampshire, included urgent cancer tests in their incentive schemes last year. North Hampshire has not continued the incentives for this year, while North East Lincolnshire insisted cancer referrals had risen.

Liberal Democrat leader Tim Farron said: ‘So we knew that the NHS was critically underfunded but now we learn that doctors are deliberately not referring people, and denying them the treatment they need, simply to save money. It looks like a bribe.’

The money is allocated to practices on an annual basis, and it is then up to doctors and managers to decide how to spend it.