Volume 19 Issue 3 September 2010Original Research
Smoothing the passage of patients from primary care to specialist respiratory opinion
Pages 248-253
Louise O’Byrnea, Camilla Darlowa, Nicola Robertsa, Graeme Wilsonb, *Martyn R Partridgeb
a
Imperial College London, NHLI Division at Charing Cross Hospital, London, UK
b
Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London UK
Received 2 February 2010 • Accepted 23 March 2010 • Online 14 May 2010
Abstract
AIMS: To assess whether information in general practitioner (GP) referral letters provides a basis for selection of diagnostic tests in patients referred for specialist respiratory advice. METHODS: We undertook a prospective study within a respiratory outpatients department to compare the diagnostic tests planned at three stages of the referral/specialist consultation process: i) using the GP referral letter alone; ii) using the referral letter and patient history; iii) using the referral letter, patient history, and clinical examination. RESULTS: Analysis of the content of GP referral letters revealed wide variations in referral information. A high proportion of tests selected using the referral letter alone were altered after specialist history-taking and examination. Far fewer changes were recorded between history-taking and examination. CONCLUSIONS: Neither literature review nor our study support a system which bases diagnostic test selection on GP referral letters alone. However, our findings suggest that approaches which include specialist history-taking in advance of face-to-face consultation merit further investigation.
Keywords
Respiratory, referral letter, information, diagnostic tests, consultation, primary care, secondary care, outpatients
* Corresponding author. Martyn R Partridge Tel: +44 (0)20 8846 7181 Fax: +44 (0)20 8846 7999 Email: m.partridge@imperial.ac.uk | |
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