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Growing numbers of patients are requesting NHS-funded referrals to private providers “operating outside of agreed guidelines”, fuelled by long waiting lists and “aggressive direct marketing tactics”, GPs have warned.

The GPs report the biggest problems are, increasingly, for weight management and for services to diagnose neurological disorders such as ADHD and autism — both of which have long and growing waiting lists with many NHS services. 

National NHS choice rules, known as the “right to choose”, mean all ICBs must allow and fund patients to use any provider of these services, regardless of location and as long as it has a contract with another ICB. Choice of NHS community service providers, however, is limited, partly because they are funded by block payments.

The letter from Wessex LMC to ICB medical directors calls for “ICB action to address potential patient safety and quality issues relating to the ever-expanding market of ‘right to choose’ providers”.

“It does seem that some providers are using ‘right to choose’ as a way to access the NHS market where there are long waits for local NHS services, and they sometimes use aggressive direct marketing tactics to encourage patients to choose their service.

“The public would expect that if these providers are ‘available on the NHS’ then they would be practising in line with agreed guidelines and best practice but this doesn’t always seem to be the case.”

Examples of such problems include providers diagnosing conditions based only on remote consultations and surveys and GPs being asked themselves to carry out physical assessments that should be part of the specialist work.

The LMC says NHS specialist services were refusing to recognise some diagnoses made by the independent providers for accessing follow-up services and refusing to prescribe to the patients.

Read full story (paywalled)

Source: HSJ, 16 December 2024

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