§ Mr. LilleyTo ask the Secretary of State for Health (1) what rights general practitioners have to refer patients to hospitals other than those with service agreements with their primary care group on non-medical grounds; [113860]
(2) what arrangements have been made to remunerate hospitals for treating patients referred to them by general practitioners exercising their legal right to select a hospital with no service agreement with their local primary care group; [113855]
(3) what measures exist to discourage general practitioners from referring patients to hospitals other than those with service agreements with their primary care group; [113861]
(4) in what circumstances a patient may receive out of area treatment. [113857]
§ Mr. DenhamLong-term service agreements should reflect the views of all local general practitioners and their community health colleagues in primary care groups (PCGs). These arrangements do not impinge on the clinical responsibility of GPs and consultants to make appropriate referrals.
PCGs do not alter the National Health Service (General Medical Services) Regulations 1992 which state
general practitioners may arrange for the referral of patients, as appropriate, for the provision of services.The arrangements for out of area treatment (OATs) are set out in HSC 1999/117 "The New NHS: Guidance on Out of Area Treatment". Copies are available in the Library. The OAT arrangements are used where pre-arranged service agreements are impractical. They are primarily for emergency situations, but also for cases where a patient's personal circumstances, such as the need to recuperate with a faraway relative, require referral outside the normal arrangements.
236WThere is no formal prior approval mechanism for referrals under the OAT arrangements. Local accountability arrangements should be in place to govern the way PCGs, primary care trusts and GPs refer patients in general. These may also include agreed protocols about referrals to highly specialised services and the way that the OAT arrangements are utilised.
Under the OAT arrangements, each NHS trust has a main commissioner. The main commissioner is funded for OATs through a non-recurrent adjustment to allocations as part of the overall process for setting cash limits for the financial year. NHS trusts are funded by their main commissioners.