January 2009

There has been concern at the development by PCTs of incentive schemes that aim to reduce referral rates or the cost of referrals from general practice to secondary care. These schemes often take two broad forms; either to encourage GPs to analyse and better understand their practice referral patterns and/or promote the use of alternative referral pathways to hospital services, or to encourage GPs to reduce their level or cost of referrals as an outcome in itself.

Such schemes were established with the advent of practice based commissioning, but have become more prominent and widespread in the context of a reported 16% rise in referrals from general practice in the first quarter of 2008/09 compared with this same period last year.

GPC guidance (Pdf – 84k)