NHS England has asked ICBs to act as ‘referees’ to resolve ‘tension’ between primary and secondary care around workload and referrals.
NHSE deputy medical director Dr Kiren Collison said there is ‘a lot of tension at times between primary and secondary care’ and that NHSE is ‘trying to get away from that’.
Speaking at the NHS Confederation Expo in Manchester last week, the Oxfordshire GP said NHSE has asked ICBs ‘to be a mediator’ as part of a ‘system approach’.
Dr Collison said: ‘We’ve seen a lot of tension at times between primary and secondary care. Primary care saying: “why are you dumping work on me” and secondary care “why are you not giving me the information that we need” or “this is a rubbish referral” – we get that all the time. And it comes from both sides. We’re trying to get away from that.
‘And that’s why we’ve asked ICBs to always be that facilitator, that mediator, a referee, if you like, to come in and say: these are the people we need to come to the table.
‘We need primary care, we need LMCs and secondary care, and if it’s the right setting, community services and others.
‘They are the mediators of this, because actually, this is a system approach. This isn’t just about: secondary care you do this, primary care you that, it is about what do we all need to do in the interest of the patient, for that pathway and how do we all come together to do that?
‘So I would say your ICB has that role to be that referee.’
Last month, Pulse exclusively revealed that GP leaders feared that NHS England is planning to replace the traditional system of direct GP referrals, with ICBs now being encouraged to take up an enhanced form of A&G.
According to the BMA, NHS England is hoping to roll this system out on a national level but the GP Committee for England said this risked adding barriers for patients to access secondary care.
And an LMC has recently claimed that hospitals are regularly rejecting GP referrals for spirometry, in a breach of ICB guidance.
At the NHS Confederation Expo, NHS England’s chief executive said that pilots of new ways of working for GP practices – modelled on the Fuller Stocktake – will be ‘integral to the future of the NHS’.
And NHS England’s national director of primary care admitted the jobs that newly-qualified GPs would want ‘are not there for them’.
So overloaded underfunded ICB, gets to referee between overloaded underfunded primary care and overloaded underfunded secondary care. Good luck!
can I be on the VAR panel?
What about ”locum dump”?
It’s all well and good to say all this but I’m afraid contracting trumps everything. I will simply do what’s in my contract and the rest is discretionary and increasingly bounced back.
Dear GP, I agree with you, your patient has clinical picture of CVA. I have requested an MRI brain. If it shows suspected pathology please treat accordingly. Sincerely yours, Consultant in stroke medicine.
Dear Consultant, do your own work. Kindest regards, GP.
This whole things continues to be a joke. The turkeys voting for christmas. Can’t make this up.
The ICB will have a meeting and implement the ICBs most decisive and critical dire emergency action-i.e. organise another ICB meeting. The main decision will be whether this subsequent get together is an MS teams meeting or with coffee and biscuits at the ICB HQ .
Not sure they will recall at the end what the original purpose of the meeting was.
As a notorious user of our local “Make a Difference” scheme, I have noticed that the clinical aspects of other services’ work dumping / rejecting is so rarely addressed by a doctor from their teams that it is a surprise when it happens. Usually the response is self marked with a reply from a service manager who often can’t even understand the clearly laid out facts of their own organisation’s actions, let alone comment or reflect in a way that resembles coherent thought!
Will a red card mean you can go home for an early bath 🤔
Excessive bureaucracy will not be fixed with yet more bureaucracy.
Incentives in the system are wrong, fix the system.
Primary Care has become dump for unfunded work. Each new piece of work which is not contracted, has to be funded first before it lands in Primary Care. This is the underlying principle as GPs are contractors for specified work. Primary Care also needs a definition in Contract.