Beyond healthcare

Referrals

What are referrals?

Referrals to put it simply are letters from a general practice, to the hospital. They include some relevant information about your condition, and ask the consultant or other specialist for advice or further management.

Who

A referral can be for anyone who needs care from a hospital. There is an increasing number of conditions which general practice manages – either by GPs, or by other specialists such as physiotherapists or mental health specialists who work in general practice too.

Referrals are made based on clinical need. There are often guidelines on conditions that you need to meet ahead of making a referral . This reduces the risk of the referral being rejected.

How

There are some referrals that you can make yourself such as counselling or stopping smoking services. For a referral to a hospital you’ll usually need to see a GP. They will determine your provisional diagnosis or arrange some initial tests.

There is also a new system, Patient Choice. This allows you to look at different options of where you go, based on the provider, distance and wait. We will then make a referral.

There are 3 types of referrals to different services. 

Routine: Routine referrals will take the longest amount of time. The hospital will assess you, but it will take a while. You could be referred routinely because although an issue may not be bothering you, it still needs to be looked into. Routine referrals can take 6-8 months.

Urgent: The hospital processes these quickly. They will contact you within a few weeks, and the clinicians determine whether or not the referral should be urgent.

2 Week Wait: These are the quickest ones – you will get an appointment within two weeks. These are used for the most concerning of symptoms. You should let us know if you don’t get an appointment within 2 weeks. We may call you to ensure that all is okay.

We refer because we are primary care. Essentially this means that our clinicians train broadly in all areas. If you have an issue such as a neurological issue which we cannot manage, we would refer you to a neurology consultant i.e secondary care. These consultants can refer for services that we cannot such as MRI’s or CT scans.

At the moment there are long waits, with some services being years behind. However, the government is trying to combat this by allowing patients to choose their own hospital. For example the patient could choose a hospital 45 miles away with a waiting time of 20 weeks. Let us know if you would like us to refer to different hospitals.

It depends on who you need to see and where. For example there are some self-referrals that you can do, such as counselling or stop smoking  (Stop Smoking – Healthy Hounslow ) but most of the time you will need to speak to a clinician in order to get a referral. This is because you may need to meet certain criteria in order for your referral to be accepted i.e bloods, urine test, stool tests. It’s also important to discuss your symptoms because we may be able to manage this in primary care.

 It may be because the consultant has already provided us with a management plan. This could be a change in your medication or using different techniques to manage your symptoms.

The consultant may want more investigations. This could be something like an xray. They may want a more thorough history which may mean you will need to come in and see a clinician again.

You will be informed if your referral has failed– as it resets the referral, meaning you may have to wait longer.

In most hospitals, referrals will be triaged before assignment to a consultant – this will mean that they will have a look to see if:

  1. The referral is appropriate
  2. If the severity of the referral is correct

This may mean that your referral downgrades from urgent to routine. The hospital will inform you of this, and if you feel as if this is not correct and that you need to be seen on a urgent basis, you can go about this in a couple of different ways. You can speak to the hospital and explain to the admin staff the severity of your case. They may forward this feedback to the consultant or they may ask you to speak to us. 

We will do this by either speaking to the hospital directly or emailing them. We will keep you up to date with any communication between the two of us. Please understand that this can be a slow process, and on both ends there may be a wait for communication.This is because both we and the hospital are busy. In the interim you can always call the hospital as well, explaining that the GP surgery has been in contact, and that a response is waiting.

Unless we need to do more investigations, we will do this internally. We will not contact you apart from telling you that the referral is complete. We will need the hospital letter and the consultants request before sending this referral off. Also, remember that letters do not come to us straight away. They can take weeks and months for us to receive them. If you have a copy of the letter you can send that across to us so we can action it quickly.

There are different departments and a wide range of specialists who can all input in your care. This may be in the community such as dieticians, podiatrists or a diabetic specialists and you can see them all in the local area. Consultants will all be located in hospital. There are some hospitals called tertiary care and only secondary care can refer to these. We will inform you if we cannot refer to a specific hospital and will ask you to make another choice.

 I want a private referral

This can definitely happen, we will need a couple of things from you such as what the issue is and which consultant and department you would like to go to. It can take up to 48 hours for you to receive this, and we will need your email address. They may come back and ask to provide more information about your case and we will be happy to look into this for you

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