Letting more patients bypass GPs and refer themselves to specialists risks heaping pressure on a system already in crisis
It’s a story that most people in England are familiar with: you ring the GP to book an appointment and are put on hold, only to be informed 20 minutes later that all the slots that day have been taken. Many people are struggling to book GP appointments and therefore waiting longer to be referred to specialist clinics. Satisfaction with GP services has fallen sharply, and the market for private appointments is growing.
Labour plans to allow more patients to bypass GPs and refer themselves to specialists. For those with “red flag” cancer symptoms, who could otherwise be waiting weeks to see a family doctor, this could be an improvement. Research suggests that survival rates for cancer patients are lower in health systems that adopt a “gatekeeping” system of GP referrals. A screening app or digital checklist could filter patients with a breast lump, for example, and allow them to skip this step. People can already refer themselves to a sexual health clinic, and NHS England is planning to expand this for services where GP involvement is not “clinically necessary”, such as hearing aids and podiatry.
