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Fund-holding general practices and old age psychiatry

Academic Subdepartment of Psychological Medicine, North Wales Hospital, Denbigh, Clwyd LL16 5SS

Howard R. Cattell, Consultant Psychiatrist

Department of Old Age Psychiatry, Ysbyty Maelor, Croesnewydd Road, Wrexham, Clwyd LL13 7TD

In a retrospective study, referrals to a community old age psychiatry service were obtained for local practices a year before and a year subsequent to the introduction of prospective general practitioner (GP) fund-holding. Although overall patterns of referral were the same, there was a significant reduction in domiciliary consultations requested by fund-holding GPs which was not balanced by a rise in other referrals. The findings suggest a shortfall in the number of referrals to old age psychiatry services in the light of GP fundholding, prompting speculation as to the fate of those who would otherwise have been referred.