PERFORMANCE: Basildon and Thurrock FT is to challenge NHS South West Essex over the governance of a controversial referral management scheme as it claimed it was having a “multifaceted impact” on performance.

NHS East of England recently voiced concerns over the gateway to the PCT and said it had “caused anxieties”.

A performance report submitted to the FT’s June board meeting said: “The trust had introduced a database to track any adverse incidents or outcomes associated with the delay introduced by the Primary Care Trust’s Referral Gateway…

“Given the multifaceted impact of the referral gateway,” it said, “the Board supported the medical director in challenging the governance arrangements of the gateway with the medical director of NHS South West Essex at the next medical directors’ Meeting.”

The report notes the trust’s Board recognised the “ongoing risk” that the South West Essex primary care trust may meet “significant financial challenges” this year and further delay or stop referrals.

The trust said the referral management system, run by Fortis Healthcare, “had resulted in 4,500 patients waiting for a first appointment”. It said the backlog was equivilent to a typical month of GP referrals. The PCT had advised the Trust that 1,000 would breach the 18 week target, it said.

It admitted failure on the 18 week referral to treatment target for quarter one of the 2011-12 financial year was “likely” but it “should be recording achievement of the standard” by the end of the calendar year. Board papers said the failure “heightens the risk of regulatory action by Monitor”.

It said the trust was also failing on the “symptomatic” breast screening target as a “direct consequence of the referral gateway”. It said the gateway had led to GPs “referring more patients through the two week wait route which had exceeded the Trust’s capacity”.