Referral to team members / Professionals Allied to Medicine (PAM)

In General Practice working as a team with healthcare professionals is essential, the extended team does not only include your practice and district nurses, health visitors and healthcare assistants but may involve referral to podiatrists, physiotherapists, OTs, dieticians etc. The communication of patient details and onward referral to this section of the extended primary care team is important but the list does not stop there, our dental and optometry colleagues can also be included in this section.

This template link to PAM may help you to review and reflect on this aspect of your referrals.


Describe your referral systems to team members working within your building

Our on site team consist of  5 GPs, 2 practice nurses, 3 health care assistants (double up as receptionists) 5 receptionists a secretary and a practice manager. On site we have our health visiting team (in flux at the moment due to maternity leave) and our district nurse team. We have a message book system to communicate messages taken by telephone, a district nurse referral book and our referrals to the health visitor are given verbally face to face. The practice nurses and health care assistants have access to our computer system for the purposes of referral.

Describe your referral systems to other professionals allied to medicine working outside your immediate primary healthcare team

We have standard forms for physiotherapy referral, OT referral and podiatry referral. A dietician visits and we appoint the patients (usually diabetics) on a needs basis. Our diabetic nurse uses our register and refers the patients (written) onward. If doctors want to access this service then again they will complete the standard form. The forms are scanned to the patient’s record before being sent by internal mail.

Optometrists and dentists are accessed by the patients themselves I cannot recall writing a referral letter to either. Our diabetic eye screening takes place annually by digital camera, our practice nurse arranges this. Last year we achieved 78% uptake for diabetic eye screening

Are there any constraints identified in this onward referral?

There are no systems in place to monitor and check these referrals. Long physiotherapist waits and podiatry is about 4 months.

Are the lines of communication adequate and safe?

We have experienced no problems and our patients seem to be able to access the services

Are there any issues that could be improved upon?

We could look at systems to monitor the referrals – at present the referrals to physiotherapy are hand written as are the podiatry and retinal screening letters. We could pass all written referrals on for scanning into the patients records prior to sending which would at least then improve the patient record. Currently there is a move toward electronic referrals which should make monitoring easier.   


To provide feedback on this module, please follow this link, you will be a taken to a short questionnaire which will take 5 minutes to complete.




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