The referral management centres have been blamed for interfering in the approach of referring patients for surgery. These centres that dictate the where and when of patient surgery, serve as mediators between the hospitals and GPs. Officials belonging to the British Medical Association feel that the inference lead to unnecessary delays in non-emergency operations.
The referral management centres are currently being managed by staff belonging to primary care trusts. Some of the centres are not medically qualified to provide such services. The NHS managers on the other hand claim that they improve patient experience. It is also true that these centres are capable of improving patient service as they help them in choosing a treatment at a convenient time.Musculoskeletal, neurology and ophthalmology treatment seem to occupy the utmost priority while cancer care or other urgent medical conditions are often ignored. Cornwall, Wiltshire and Oxfordshire represent some of the referral centres where such practices take place.
In some areas, GPs witness return of referral letters, without appropriate decision being made that delays further treatment. The GPs have urged the reference centers to concentrate on patients who may need immediate medical attention so that appropriate care can be provided. They have additionally highlighted the need for a strong link between GPs and consultants and a transparent system that would ensure a quick and reliable health care access.
'In some parts of the country referral management schemes are mismanagement schemes. Where may be local clinicians have been consulted and involved in designing the schemes, things working well. In other places there has been no effective consultation and it seems the main intention is to cut costs either by trying to limit referrals or by delaying them. NHS Trusts are telling GPs that non-urgent cases will not be treated until they have reached the maximum waiting time permitted within government targets,' said Dr Hamish Meldrum, Chairman, BMA's GPs committee.
'Referral management schemes have nothing to do with rationing care - they simply help to ensure patients see the most appropriate clinician in the most convenient setting. If somebody needs to be referred to hospital then clearly they should be referred. It's down to the local NHS to make sure that patients have access to the services they need. But it is good management to look at whether some referrals could be better dealt with in a primary care or some other local setting,' said a spokesperson for the Department of Health, in response to the above criticism.
