Thousands of patients face being denied access to hospital care under tough new rules to ration treatment as NHS bosses step up desperate efforts to make millions of pounds in savings.
Under the regime in North Yorkshire, a series of thresholds restricting access to routine hospital care for new patients are being drawn up.
Numbers of patients returning to hospital for specialist check-ups will be cut by more than half, with follow-up consultations axed altogether in some fields.
In some parts of the county, GPs will need a second colleague to approve a hospital referral and new monitoring will be put in place to check how many patients practices send for specialist care.
The measures come as health chiefs battle to prevent the NHS in the county falling further into the red, with debts already due to total £19m by March, and ahead of a radical shake-up to be announced next month which will see hundreds of hospital beds axed and services withdrawn.
The Yorkshire Post understands top-level talks involving Health Secretary Jeremy Hunt will also be held next week as part of efforts to secure solutions to the county’s immediate debt crisis and long-term funding shortfall.
Coun Jim Clark, chairman of North Yorkshire County Council’s health scrutiny committee, said the changes put care at risk.
“These are cuts to front-line care,” he said. “People are beginning to realise there are going to be fundamental changes to services and it’s causing a great deal of concern.”
Eye specialist Tim Dabbs, who is based at St James’s Hospital in Leeds and represents Yorkshire on the Royal College of Ophthalmologists council, warned any reductions in hospital checks for those at risk from serious eye complaints would be a “catastrophe”.
“GPs are not able to monitor a number of eye conditions effectively and neither are optometrists – it has to be done by ophthalmologists,” he said. “If anybody reduced the follow-up for these patients you are going to get cases of permanent and irreversible sight loss.”
Clara Eaglen, from the Royal National Institute of Blind People, said it was concerned that if restrictive criteria were developed it could lead to “serious and unnecessary sight loss”. “We believe that nothing should impact upon the patient’s right to get timely treatment and we will be looking into this further,” she added.
Boroughbridge GP John Crompton, chairman of North Yorkshire Local Medical Committee, which represents family doctors who will head new clinical commissioning groups (CCGs) from April, said hospital referrals and admissions in the county were lower than many other parts of the country.
He said the vast majority of referrals were “genuinely needed” and patients also required follow-up investigations, reviews and tests in hospital.
“Our concern is that it will put more pressure on GPs dealing with more and more people who are ill at home and in the community and that requires extra services and more resources,” he added.
Tory MP for Skipton and Ripon Julian Smith said he had been surprised by health chiefs’ “lack of engagement and communication” over forthcoming changes. A number of meetings between MPs, Ministers and key stakeholders were planned in coming days.
“I am confident that with better communication and discussions we can get on top of the current situation and ensure concerns are fully addressed,” he said.
NHS North Yorkshire and York director of finance Alan Wittrick said it had faced “serious financial difficulty for a number of years”.
“The way services are currently delivered is not sustainable. We must look to new ways of working to ensure the CCGs are in the best possible position when they take over the majority of NHS commissioning in April 2013,” he said.
“We know there will be some difficult decisions to make. However, we want to reassure the public that providing high-quality, sustainable services remains our top priority.”