A recent survey indicates that approximately a quarter of patient referrals to hospitals are being rejected and sent back to general practitioners (GPs). This practice, often categorized as "advice and guidance" (A&G), is reportedly occurring even when GPs did not request such advice.
The survey, which polled 712 GPs for the healthcare magazine Pulse, found that doctors estimate 26 percent of referrals are returned under the A&G category. The A&G system is intended for GPs to seek specialist advice before a formal referral, but unsolicited returns mean patients who were meant for hospital consultation are being sent back to their GP for specialist input.
Further exacerbating concerns, family doctors reported that 36 percent of the A&G they received required them to undertake tasks outside their usual remit. One GP in the North East warned that this process is creating "increasing barriers to two-week wait gastrointestinal referrals" for patients with potentially serious, red-flag symptoms indicative of cancer.
Dr. Clare Bannon, chair of the GPs committee at the British Medical Association, stated that hospital trusts are contractually obligated to accept referrals from general practice unless very specific circumstances apply. "Referrals should not simply be rejected with requests for additional GP actions unless part of a locally agreed pathway," she told Pulse.
A spokesperson for the Department of Health and Social Care defended the A&G model, asserting that it has helped millions of patients receive care in the correct setting without needing to join elective waiting lists, thereby facilitating timely and appropriate care in primary and community settings.