To think the gp shouldn't do this?

[Edenviolet]

Dd1 recently had a hospital appointment to see her consultant. Everything was discussed and decided that dd should see an orthopaedic doctor every 3 months to monitor her problem.

Got a letter yesterday summarising the appointment and that the gp had been asked to send a referral to orthopaedic dept. gp surgery phoned me today to say I need to take dd in to see them so they can decide if the referral really is necessary???
Surely if dds consultant feels it is after tests and seeing dd then its not the GPS place to decide, they should just do the referral as requested by the consultant ( and I'm not sure why the consultant wasn't able to refer directly and had to request the gp to do it?)

I just want dd1 seen and this will delay her first appointment.

It just seems like a waste of an appt for the gp to have to see dd when all tests results etc were sent to them-they can see from that she needs the referral ASAP, instead I have to wait over a week for an appt just for them to say they agree and then refer when ideally they should just refer now. Its very frustrating.

Because there'll be costs involved somewhere down the line and no one wants to be the source of the referral unless it's absolutely 100% crucial to survival because then the costs come out of their budget.

It's money. Pure and simple.

If the consultant refers direct then the hospital cannot make a charge for it. If they ask the GP to refer then the hospital are able to charge a fee/recoup costs, however you want to put it.

Costs come from GPs budget so they want to make the decision if it's worth paying for. Consultants can recommend a referral, or make one without charge available to the hospital, but they cannot demand a GP spends their pot of money in a certain way.

Sucks doesn't it.

I hope they do refer her, she has scoliosis and has been in a lot of pain, the consultant said she needs to be reviewed every 3 months as might need surgery if it worsens any more. On top of her other problems its just more worry as she's in pain every day now with back/neck/shoulder.

That is standard practice at our surgery. I have never had the GP refuse the referral, if anything they sent it more urgently after seeing for themselves what the issues were.
It also got the GP notes up to date with any important changes to treatment. So not a wasted journey, though I can see why it seems like another delay.

Very sorry for your dd OP.

I'd be making sure the referral was to the best paediatric orthopaedic surgeon I could find in the area. Don't forget the ability to choose and book. Better to drive 3 hours and get the very best available IMHO.

Exactly, Eggy, hospital specialties can't do inter hospital referrals because the hospital only gets money for the referral if it has come from the GP. Crazy, isn't it? Sorry you're getting messed around, OP, but I suppose if the GP is being expected to make the referral it's reasonable for them to want to see your daughter first.

It is just frustrating, more so I think as we had to wait months recently for her cardiac investigations and table tilt test so just wanted this appt as soon as possible as things have not been going well in general.

Fingers crossed we get the referral sorted out and don't have to wait too long. Its a shame the gp can't just do it without seeing her but hopefully they will agree with the consultant. I didn't realise there were costs to the gp involved for making a referral.

Hospitals can and do get paid for consultant to consultant referrals, it's just that commissioners (GPs!) try to limit the number they do via targets in contracts.
I suspect the GP may be attempting some sort of gate keeping as now they are commissioners they are responsible for demand management.

Hope the referral goes through quickly and there is no delay for your DD.

If OP is in Scotland the GP gets paid for the referral but will want yo check first as its their name on the line. Works differently here to NHS England.