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Friday, December 16, 2011

NHS managers restricting access to crucial scans and tests to save money

NHS managers are trying to restrict access to crucial tests and scans in a move that could mean diseases being diagnosed later. 


An investigation has found that a quarter of Primary Care Trusts are either investigating how many patients individual GP practices send for examinations or looking for ways to reduce the numbers.


In addition, a handful are identifying “excessive” use of the tests or setting upper targets while others have completely stopped letting doctors have direct access to the scans.


Experts said the tactics could lead to patients being diagnosed later with diseases such as cancer, which research shows lowers survival chances.


Dr Clare Gerada, head of the Royal College of GPs, said: “This is about money and finances driving behaviour by the PCT – not about putting patients first.”


Cancer Research UK’s director of policy, Sarah Woolnough, added: “It is very worrying to hear of PCTs setting referral targets and decommissioning direct access to tests that could speed up a cancer diagnosis.”


Meanwhile, official figures show that even patients who are being referred to hospitals for tests are being forced to wait longer than a year ago.


Department of Health statistics show that 10,700 patients were waiting more than six weeks for any one of 15 key diagnostic tests at the end of July, a rise of 7,000 on the figure for the previous year.


The Government has told health service managers to improve direct access to diagnostic scans such as MRI, CT and ultrasound in order to improve early diagnosis of cancer and heart disease.


But an investigation by GP magazine suggests that many trusts want to reduce the number of patients sent directly to tests at specialist centres in order to save money.


Of the 116 Primary Care Trusts contacted, 28 per cent said they had either started looking into how many referrals GPs carried out across their area, or were planning to do so. A quarter are helping practices reduce inappropriate access.


Nine trusts said they had found surgeries that either sent too many or too few patients for tests while two are considering introducing upper and lower targets.


Five PCTs have scrapped direct access altogether to at least one type of test.


Dr Chaand Nagpaul, a leading member of the British Medical Association, said restricting access to scans risks “turning back the clock” on plans to diagnose disease early.


“An intelligent approach would be to have guidelines for appropriate use of diagnostics and incorporate them into the pathway.”


The moves are the latest example of how managers are rationing patient care in an attempt to make unprecedented efficiency savings totalling £20billion across the NHS by 2015.

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