GPs urged to refer directly to the independent sector
Helen Mooney
Health Service Journal, 9 August
Western Cheshire primary care trust has told doctors across its
patch to refer orthopaedic patients needing hip and knee
replacements directly to an independent sector treatment centre
because it is under-used.
A letter sent on 31 July to Western Cheshire GPs from PCT
director of commissioning and health outcomes Graham Atkinson
and chair of the professional executive committee John Hodgson
asks GPs to refer directly to the Cheshire and Merseyside ISTC.
At present GPs in the area first have to refer orthopaedic
patients to an orthopaedic triage service run by the PCT.
'The decision has been taken due to the scale of the treatment
centre contract, which is currently being under-utilised,' the
letter says.
'The PCT must pay for this activity whether or not it is used
and, in 2007-08, the contract is worth £6.9m.'
GPs will be monitored at practice level on the number of
referrals they make to the ISTC and will get a budget allocation
for use of the centre as part of their indicative practice-based
commissioning budget.
Western Cheshire PCT chief executive Helen Bellairs said the
move was not trying to cut patient choice.
'On the contrary, we have merely stressed to GPs the importance
of considering the ISTC as an option for patients. It is
appropriate that we should utilise all of our contracts to
ensure best value for money.'
She said use of the ISTC was shared between eight PCTs but that
Western Cheshire had a 'larger than fair share of the contract'.
The centre, run by Interhealth Canada subsidiary Interhealth
Care Services, is part of the government's wave one ISTC programme.
The Cheshire and Merseyside ISTC, which opened in June 2006, is
worth £120m over five years. It is contracted for 5,000
operations a year.
A second Interhealth ISTC worth £26m provides orthopaedic
surgery at Kidderminster Hospital.
Janet Soo-Chung, chief executive of debt-ridden North Yorkshire
and York PCT, also sent a letter to GPs last week encouraging
them to take 'action to fully maximise' use of a York-based ISTC
run by Capio Healthcare UK. This ISTC was also procured under
the wave one scheme and Capio is paid regardless of the work the
centre does.
The ISTC scheme has faced criticism from the NHS after it
emerged private companies running centres are paid millions of
pounds for five-year contracts whether or not they carry out work.
Wave one ISTC procurement has been dogged by under-use; in 2005
HSJ revealed Greater Manchester surgical centre had lost the
health economy nearly £2m in its first six months (news, page 7,
15 December 2005).
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