Referral and Choice

Informal Advice on Referral Processes and Patient Choice

In recent months we have received a number of requests for informal advice on how the Principles and Rules for Cooperation and Competition (Principles and Rules) might apply to:

• arrangements that seek to manage referral processes operated by providers in a way that may affect patient choice or competition, for example where GPs or a provider of community services or hospital-based care operates a referral management service; and
• financial incentives which relate to referrals.

We would like to review some examples of these sorts of arrangements to understand them better and identify good practice.

As these issues have broader application to the design and commissioning of patient treatment pathways, we have decided to provide some informal advice using case studies to illustrate how the Principles and Rules might apply to these sorts of arrangements.

APPROACH

We will analyse the costs and benefits which may arise from these arrangements and in particular will consider the application of:

• Principle 5, Commissioners and providers should promote patient choice, including – where appropriate – choice of any willing provider, and ensure that patients have accurate and reliable information to exercise more choice and control over their health care; and
• Principle 6, Commissioners and providers should not reach agreements which restrict commissioner or patient choice against patients' and taxpayer interests.

The case studies will be based on examples of referral processes provided by commissioners and providers. Our informal advice will include recommendations to support commissioners to design services in the patient care pathway that are consistent with the Principles and Rules.

TIMEFRAME FOR SUBMISSIONS

The CCP invites submissions in writing from interested individuals and organisations on this issue.

It is proposed that submissions are provided by Tuesday 5 March using the email address: cases@ccpanel.gsi.gov.uk.