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Government wades into Birmingham referrals row

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The government has waded into the row between a leading foundation trust and a group of commissioners after closing its doors to “out of area” referrals for routine care.


Health minister Dan Poulter has met Worcestershire MPs who are concerned that patient choices has been restricted after University Hospitals Birmingham Foundation Trust began refusing referrals for secondary care from outside the city last month.

Two MPs whose constituencies were affected, including the culture secretary Sajid Javid, raised the issue with Dr Poulter, according to local newspaper reports.

The minister confirmed the government was aware of the trust’s action.

He said: “I am personally keeping a close eye on developments and am committed to finding a solution, as quickly as possible, that protects patients’ legal rights to exercise choice.”

The trust is refusing referrals for secondary care across five clinical specialisms for patients who live outside Birmingham, which its leaders regard as its natural local catchment area.

The restriction is initially in place for three months, and has angered clinical commissioning groups in neighbouring counties whose populations often choose UHB over providers closer to home.

Daniel Poulter

Dan Poulter said he is ‘personally keeping a close eye on developments’ at UHB

A DH spokeswoman told LGC’s sister title Health Service Journal that offering choice was the responsibility of both the commissioner and the provider, pointing to the NHS Choice Framework and NHS Constitution.

Dr Poulter has said he expects Monitor to lead efforts to resolve the issue. The regulator has indicated it was up to commissioners to ensure choice for patients.

“It is the responsibility of commissioners to ensure that patients are offered a choice and are aware of their right to choose where they go for treatment,” a Monitor spokesman said, citing regulations from 2012 which were aimed at NHS England and CCGs only.

The spokesman added: “We are ensuring that the parties are coming together to resolve the situation on behalf of patients and are working to facilitate an open discussion of the issue.

“We have been in contact with the relevant commissioners who are seeking local resolution through the contracts they hold with UHB, and we will write to the trust shortly.”

While the dispute has not been formally referred to Monitor, the regulator is hoping it can help the trust and commissioners reach an agreement.

NHS England’s Birmingham and the Black Country local area team are also being kept informed, but are not formally involved in the discussions.

HSJ understands the commissioners outside Birmingham, whose patients are most affected by UHB’s decision, are still hoping that the area team and Monitor will force the trust to reconsider.

A UHB spokeswoman said: “[The trust] is aware that MPs have written to the minister but we have had no direct contact from him.

“The trust understands that it is the responsibility of the commissioners to provide patient choice. The current situation regarding referrals is not due for review until the initial three month period has elapsed.”

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