GP referrals drop for the first time in six years

The total number of GP referrals has fallen by 2% in the last year, the first decrease since 2011, breaking the trend that saw the figure rise by 22% in the past eight years.

Between 2016 and 2017, the total number of referrals to secondary care decreased from 13.9 million to 13.6 million, a Pulse analysis of NHS England data has shown.

This follows annual increases of between 2% and 6% every year since 2011.

Pulse’s ‘Cash for cuts’ investigation has found that, despite GPs’ success in reducing referrals, many commissioners are implementing schemes that reward GPs for reducing their overall referral numbers – which has been described as ‘unsafe’ by GP leaders.

More on Pulse’s ‘Cash for cuts’ investigation

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Cash for cuts: GPs incentivised to reduce referrals

GPs offered up to 50% cut of savings generated by slashing their own referrals

How the ‘Cash for cuts’ referral schemes work

Imperial College primary care and public health department chair, Professor Azeem Majeed, said: ‘GP referrals are important. However, NHS England should be focusing on improving staffing levels in primary care – GPs and other health professionals – by improving recruitment and retention.

‘A better staffed and funded primary care system would help take the pressure of other parts of the NHS. In recent years, we have seen the opposite trend, with the proportion of the NHS England budget going to primary care falling.’

Dr Andrew Green, prescribing policy lead for the BMA’s GP Committee, said it was ‘not possible make any firm conclusions based on one year’s figures, as individual decisions to refer are based on many factors in addition to the patient’s clinical condition’.

He added: ‘Referral rates may be altered in a constructive way by increased availability of effective alternatives to traditional referral, or in a negative way by CCGs failing to commission effective secondary care services, or placing barriers in place which restrict access to procedures from which the patient may benefit.’