Referral letters 1

Audit of referral letters, reason for referral

Referral Letters 1

This section may be used by a doctor to examine and reflect on the reasons that referrals are made. There are many factors that influence a doctor’s request for a second opinion not strictly related to clinical need. The reflective process may help you to identify areas that influence you and may throw up learning needs.

Using the template below complete as fully as possible for the next ten referrals you make (you could either concentrate on one specialty that makes you feel “uncomfortable” or you can just analyse your next ten referrals).  

Please note this example is only a five stage audit, however it should be fairly simple to convert to an eight stage audit by repeating the data collection at an interval.

Reason for Referral Template

Are there any issues you would like to record about the referrals above?

Are there any learning points?

Reason for Referral Example

Are there any issues you would like to record about the referrals above?

By recording my thoughts at referral I was quite surprised that a number of these referrals were generated mainly through pressure from patients or relatives. These 10 referrals were generated in a 3 week period during which time I had consulted with 162 patients. Overall my referral rates within my practice are comparable to my partners. The nurse run clinic for nebuliser assessment is a good resource and we have similar clinics for insulin conversion, Sigmoidoscopy and paediatric dermatology.

Are there any learning points?

I need to examine the guidelines for tonsilar surgery to be able to advise other patients appropriately. I wonder if I need to be a little more assertive in dealing with patients who are only partially investigated for example the patient whom I referred without performing spirometry (this may also point toward my poor knowledge regarding interpretation of spirometry), and patient who are only partially treated – the young child with eczema and the issue of prescribing tacrolimus.


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