This week saw one of the most interesting events of recent times take place. No, it definitely wasn’t the Conservative Party Conference but the issuance of a notice by University Hospitals Birmingham NHS Foundation Trust to West Midlands GPs announcing that it will no longer accept out-of-area referrals for secondary care that could be done by neighbouring providers. Is this a bold, sensible and necessary, if unpopular, approach to addressing growing demand or does it flout the strict rules around patient choice? Whereas operational pressures may be the cause of the decision, this is a strategic issue that allows us to examine a very important concept in service and Trust reform.
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