Hartlepool MP’s fears that GP referral pilot could lead to delays in patients’ treatment

Hartlepool MP Mike Hill.
Hartlepool MP Mike Hill.

Hartlepool’s MP fears a new GP referral assessment system could lead to unnecessary delays in patients getting the treatment they need.

Mike Hill described the pilot Clinical Assessment and Peer Review (CASPeR) system as an unnecessary level of health provision and a cost cutting exercise.

NHS Hartlepool and Stockton Clinical Commissioning Group (CCG), which is launching the pilot, says it should reduce pressure on hospitals by preventing unnecessary admissions.

Under the system, potential referrals to hospital by GP will be submitted to an assessor to decide if the patient can be treated in another way.

Mr Hill said: “I am aware that in other areas where such schemes have been introduced, concerns have been raised about how they could compromise patient safety and I repeat those concerns.

“Looking at it, it appears that everything except cancer will be affected and that is a massive issue for me as the local MP.

“This appears to me to be an unnecessary extra tier of health provision being introduced, and is clearly also a cost cutting exercise.

“My fear for the people of Hartlepool is that it could lead to unnecessary delays in treatment and therefore could have a negative effect on care and outcomes.”

The CCG said the system should reduce the number of patients being referred to hospital when they do not need to save money, but denied that was the reason for the pilot.

A spokesman said: “The process will increase the overall level of quality of care delivered to patients, ensuring everyone is treated to the same high standards of care regardless of which practice that are registered with or who they see.

“From a patient perspective it will also reduce wasted appointments to secondary care and support them being treated closer to home where this is possible. We will closely monitor the scheme and there is no evidence, from roll out of very similar schemes in other areas, to suggest that it causes any additional clinical risk or delay to treatment.”

What is the Clinical Assessment and Peer Review System?

NHS Hartlepool and Stockton Clinical Commissioning Group (CCG) says it is an additional specialist clinical opinion tool to help make the most appropriate decision on treatement for routine patient referrals.

Utilising a set of agreed clinical criteria, referrals will be assessed within two working days and a decision made as to whether the referral should be processed in the usual way, if alternative services should be explored first, or patients require additional examinations/diagnostics prior to the referral being submitted, this will be returned for the patient’s GP for further action.

Why is it being introduced?

The CCG says it needs to use NHS resources wisely to deliver high quality care to patients.

It want to address differences in referrals between different GPs by introducing a tool to support GPs when considering a referral for further advice on management of a patient.

Who assesses the referrals?

GPs and GPs with a specialist interest with support from consultants where required.

What is covered by the assessments?

What medical specialties are included in this scheme?

Eight specialities have been identified of Gynaecology, Rheumatology, Ears, Nose and Throat (ENT), Dermatology, Urology, Cardiology, Ophthalmology and Gastroenterology.

What about two week wait (cancer) referrals?

These are excluded from the process. CASPeR will not be used for these.

What happens if a patient’s medical need is urgent?

If the referral is urgent, it is expected that the referrer would speak directly to the consultant or on-call team about urgent clinic availability as per existing processes.

This is not part of the CASPeR process and the CCG says will not delay treatment.

What if a patient doesn’t need to be referred on to a specialist?

The referrer will receive advice on a clear suitable management plan based on up to date guidelines and local service availability.