GPs disregard HSE advice on outpatient referrals due to patient safety concerns

Growing concern for patient safety following the HSE ransomware attack has prompted GPs to disregard HSE and IMO advice asking them to avoid submitting outpatient referrals to secondary care, it has emerged. 

The shutdown of HSE IT systems, which struck the health service almost two weeks, has significantly affected GP referrals to outpatient departments (OPD). 

Healthlink, a secure communications service between primary and secondary care, is not operational and electronic referrals to rapid access clinics have also been impacted. 

HSE Chief Operations Officer Dr Anne O’Connor said outpatient services would operate at around 40 per cent capacity this week as work continues to restore systems. 

Monaghan GP Dr Illona Duffy said hospitals should instead accept outpatient referrals in writing. Such referrals, she said, could then be logged until services resume. 

“I don’t accept that they cannot continue to accept referrals in paper form. That’s not acceptable or fair for patients and doctors to continue to provide care in the community without support,” Dr Duffy told the Medical Independent . 

“We have a duty of care to our patients. It is not acceptable for us to delay sending in referrals. Yes, they may not be able to process them, but they could take them in and log them and process them when systems are up and running.

“We’re still sending in our referrals because what are we meant to do with them? We need to get them in. We’re telling the patient there will be a delay and making them understand that we can’t guarantee when they will be seen but if we have urgent referrals we have to send them in.”

Dublin GP Dr Alex McVey said he had ignored advice on the basis that it was unsafe for patients. He is submitting OPD referrals by post, he outlined in a recent Twitter post. 

GPs currently have no access to blood tests unless they are considered urgent and essential. Talks are underway to provide access to laboratory tests using private facilities, it is understood. 

Patients treated under the chronic disease management programme in general practice have been impacted, as their bloods cannot be processed and returns are made via Healthlink. 

Payments to GPs via the HSE Primary Care Reimbursement Service (PCRS) system will likely be reduced in June as claims are not being received by the PCRS. 

Capitation and practice supports only will be paid in June. GPs have been advised to keep a record of all STC claims and to save but not submit Covid-19 and chronic disease management claims. 

In an email communication to members, the IMO advised that it is meeting with the PCRS to address the matter to ensure “adequate cash flow to general practice”. 

Medical certificates for illness benefit claims, previously submitted through Healthlink, must now be submitted by post.