Original Article

General practitioner referral audit: are the new Clinical Prioritisation Criteria required?

Ryan Wei Sen Goh, Lauren Elizabeth Styan, Craig Anthony Bond, Johannes Christiaan Oosthuizen


Background: Referral letters are frequently the only source of communication between primary health care providers and specialists. To ensure the safe handover of patient care, these referral letters should be written to an appropriate standard to provide sufficient detail about the patient’s overall clinical picture. Our aim is to ascertain the quality of information contained in referrals received by the Otolaryngology, Head and Neck Surgery Department at Ipswich Hospital (Queensland, Australia), and to consider whether a change of the referral pathway is warranted.
Methods: One hundred and twenty-two referrals were randomly selected in July 2018, and scored against the Ipswich Hospital referral requirements (maximum score of 32). Scores were separated into four categories: patient demographics, referring practitioner details, relevant clinical information, and condition-specific information.
Results: The mean overall score was 21.4 (67%). Paediatric and adult referrals scored similarly at 21.7 (68%) and 21.2 (66%) respectively. When considering the four subsections, the referring practitioner’s details scored the highest (91.7%), whereas the relevant clinical information scored the lowest (50.9%).
Conclusions: To ensure the safety of the patient and a well-functioning public health service, referral letters need to be written to an adequate standard to enable accurate categorization of outpatient appointments. The results of this study demonstrate poor compliance with current set referral guidelines. This in turn has implications with regards to the accurate triaging of referrals received. This has initiated the introduction of the Clinical Prioritisation Criteria (CPC) guidelines, which are welcomed. Time will tell whether the introduction of these will ultimately enhance the quality of referrals received.

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