I think because it just gives you a standard doesn’t it, that you are sort of both [referring and receiving clinician] singing from that same hymn sheet so everyone knows what they are looking at whereas before it was very descriptive for DVT [deep vein thrombosis]… and it’s, now it is well if they hit this rating then they almost have to accept them so it just makes it easier to and things like the sort of TIA [transient ischaemic attack ABCD2 score]… all those things, it just means that you, you are speaking the same language with someone on the phone who hasn’t actually got the patient in front of you. FG2R5 (family physician, medically qualified 18 years) I would say probably more [the] case in secondary care, partly because the pressure for the juniors there is not to admit people, and so people tend, and unfortunately be very defensive and so they will use tools that are meant to be there as tools, they will use them as tools to reject admissions. FG2R8 (family physician trainee, medically qualified 5 years)