‘Too much paperwork’ in referring patients to England

Doctors say the level of bureaucracy involved in referring patients to specialist care in England is “too much to deal with”.

Politicians in Westminster are exploring the situation in healthcare at the border between England and Wales to see if lessons can be learned from both sides.

Last year the Secretary of State for Wales, Jo Stevens, and the First Minister of Wales, Alund Morgan, announced plans for greater NHS collaboration to reduce waiting times.

Written evidence from the British Medical Association (BMA) in Wales to the Welsh Affairs Select Committee highlighted the frustrations and difficulties consultants experience when referring their patients to cross-border services.

The doctors’ body said Wales “lacks many specialist services which can be obtained in England, but the ease of such access can vary hugely”.

It states that the bureaucracy can be “extremely time-consuming” and that some consultants have received requests for a second opinion, yet “the reason for referring the patient to a specialist service in England is that such a local opinion/ Expertise does not exist”.

The committee will hear evidence on Wednesday from Dr David Bailey, former chair of the Welsh Council at the BMA, and Dr Stephen Kelly, chair of the Welsh Advisory Committee, who point to disparities in the quality and timeliness of care when referring patients to secondary care. ,

This may also arise in the way the data is collected, as patients referred to English trusts may be “ignored” in waiting list statistics because England has different targets.

However, the BMA in Wales said it was unclear “whether patients being referred to England are counted on the Welsh waiting list”.

Powys Teaching Health Board recently discussed asking hospitals in England to do the same Welsh patients given delayed careTo save money without violating Welsh waiting times.

The county does not have its own district general hospital and is dependent on hospitals located on the border.

Access to patient records and referrals is also hampered due to the different IT systems used.

The evidence included the example of a senior consultant based in Wales with experience of running various health services.

Specialist services were not available in Wales, but for treatment over the border they required an Independent Patient Funding Request (IPFR), with consultants from England writing to the health board in Wales.

“Inefficiencies in the system led to individuals feeling they had no choice but to pay privately for some of their treatment,” the evidence said.

“A non-doctor or someone working outside the NHS would have struggled to navigate the system.”

In addition to specialist services, the BMA in Wales said the latest figures showed there were 13,300 Welsh residents registered with GPs in England, and 21,100 English residents registered with doctors in Wales.

Nearly 27,000 Welsh residents were on the waiting list for care in England in March last year – more than double the number recorded in 2011.