Patient Information: NHS contract changes

Improvements for patient services to speed up treatment and improve outcomes

Changes to the NHS standard contract between Clinical Commissioning Groups (CCGs) and provider trusts in April 2016 allowed for onward referral of patients by secondary care clinicians rather than having to always require referral back to the originating GP.

The new contract states that where a patient has been referred to one service within a provider by a GP, or has presented as an emergency, the provider clinician is allowed to make an onward outpatient referral to any other service, without the need to be referred back to the GP, where:

  • Either the onward referral is directly related to the condition for which the original referral was made, or which caused the emergency presentation (unless there is a specific local CCG policy in place requiring a specific approach);
  • Or the patient has an immediate need for investigation or treatment (suspected cancer for instance)

By contrast, the contract does not permit a secondary care clinician to refer onwards where a patient’s condition is non-urgent and where the condition for which the referral would be made is not directly related to the condition which caused the original GP referral or emergency presentation.

This is an important change, welcomed by the medical profession, who recognise the advantages/convenience for both patients and clinicians