Generic outpatient referrals: why don't GPs make them?

Aim: Generic general practitioners' (GPs') referrals to secondary care would facilitate equitable distribution of workload and allow planning to meet access time targets. This study assessed GP's referral patterns across a metropolitan health authority, which has actively encouraged generic referrals.

Methods: A focus group of GPs was used to determine the factors influencing their referral patterns to secondary care for a surgical opinion. A questionnaire was devised based on the factors that emerged from the focus group. All GPs attending continuing-medical-education sessions across Doncaster Health authority were asked to complete this questionnaire.

Results: Of the 79 GPs surveyed, 78 completed the questionnaire. Of them, 22% stated that they made generic referrals rather than to an individual surgeon. Almost four of five GPs made referrals specifically to a named surgeon. A total of 43% of the GPs who referred to a named surgeon ranked perceived clinical skills/ competence as the most important factor. The other factors that influenced their decision in order of importance were waiting times (19%), personal rapport with consultant (12.6%) and feedback from patients (12.6%).

Conclusion: Despite encouragement by secondary care and the local health authority, 78% of GPs in the Doncaster area do not make generic referrals. This has to be taken into account in planning service delivery.