Table 2.

Desired content of referral letter and specialist letter

Category	Referral letter	Specialist letter
Purpose	Reason for referral Level of urgency	Purpose of the letter
Medical facts	Active diagnoses/history Resuscitation policy Medication allergies Medication names Medication doses and frequencies	Active diagnoses/history Resuscitation policy Medication allergies Medication names Medication doses and frequencies Any clinical trial the patient is involved in*
History	Presenting symptoms History of symptoms	Presenting symptoms
Psychosocial information	Need for an interpreter
Diagnostic pathway	Physical examination: Aberrant findings, relevant for current problem Investigations: aberrant findings, relevant for current problem	Physical examination: aberrant findings, relevant for current problem Investigations: aberrant findings, relevant for current problem
Diagnosis		Provisional diagnosis/diagnosis Whether tumour is localised of metastasized Description of size and direct expansion of primary tumour** Description of expansion to regional lymph nodes Description of distant metastasis
Treatment		Treatment options Selected treatment (e.g. watchful waiting or surgery) Explanations for chosen treatment Aim of treatment: curative or palliative Summary/conclusion of multidisciplinary consultation Prognosis with treatment Short-term side-effects of treatment* Effective initiated treatment Response on initiated treatment
Completion		Summary/conclusion What the patient has been told For what problems should the patient contact the medical specialist? Whom should the patient contact Specific request to the GP
Hospitalisation		Discharge destination Complications Medication changes Complete medication list Active medical problems at discharge Intentions regarding residual medical materials (e.g. drains or stitches)

*Less relevant in round 1

** Less relevant in round 1 and also overall score < 70% in round 2 (62.7%), but included because 71.4% for GPs in round 2