Abstract
BACKGROUND. Wide variations in rates of referral from primary to secondary care have been a matter of concern for many years. Effective strategies for optimizing referral depend on doctors being able to understand what the influences on their referral behaviour are, as well as having the ability to identify priority areas for action and to develop strategies for pushing through effective measures. AIM. This study set out to ascertain general practitioners' priorities for change with respect to the referral process, and to set an agenda for change to be tackled by general practitioners, providers, policy makers and educationalists. METHOD. Through the use of the Delphi technique and focused interviews, general practitioners throughout Northumberland contributed to the consensus view. RESULTS. The main themes to emerge related to hospital waiting lists, open access, flow of information between secondary and primary care and general practitioners' knowledge and training. Ideas for implementing change included the production of directories of hospital services and the development of guidelines for the use of the term 'urgent' in referral letters. CONCLUSION. All of the proposed changes are manageable and share the burden between general practice and other professionals with an interest in the referral process.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bond S., Bond J. A Delphi survey of clinical nursing research priorities. J Adv Nurs. 1982 Nov;7(6):565–575. doi: 10.1111/j.1365-2648.1982.tb00277.x. [DOI] [PubMed] [Google Scholar]
- Burns T. J., Batavia A. I., Smith Q. W., DeJong G. Primary health care needs of persons with physical disabilities: what are the research and service priorities? Arch Phys Med Rehabil. 1990 Feb;71(2):138–143. [PubMed] [Google Scholar]
- Hutchinson A., Fowler P. Outcome measures for primary health care: what are the research priorities? Br J Gen Pract. 1992 Jun;42(359):227–231. [PMC free article] [PubMed] [Google Scholar]
- Newton J., Hayes V., Hutchinson A. Factors influencing general practitioners' referral decisions. Fam Pract. 1991 Dec;8(4):308–313. doi: 10.1093/fampra/8.4.308. [DOI] [PubMed] [Google Scholar]
- Noone A., Goldacre M., Coulter A., Seagroatt V. Do referral rates vary widely between practices and does supply of services affect demand? A study in Milton Keynes and the Oxford region. J R Coll Gen Pract. 1989 Oct;39(327):404–407. [PMC free article] [PubMed] [Google Scholar]
- Reynolds G. A., Chitnis J. G., Roland M. O. General practitioner outpatient referrals: do good doctors refer more patients to hospital? BMJ. 1991 May 25;302(6787):1250–1252. doi: 10.1136/bmj.302.6787.1250. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stocking B. Promoting change in clinical care. Qual Health Care. 1992 Mar;1(1):56–60. doi: 10.1136/qshc.1.1.56. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wilkin D., Smith A. G. Variation in general practitioners' referral rates to consultants. J R Coll Gen Pract. 1987 Aug;37(301):350–353. [PMC free article] [PubMed] [Google Scholar]
- Wilkin D., Smith A. Explaining variation in general practitioner referrals to hospital. Fam Pract. 1987 Sep;4(3):160–169. doi: 10.1093/fampra/4.3.160. [DOI] [PubMed] [Google Scholar]