13. Referring patients

When indicated. It is in patients’ best interests for one doctor, usually a general practitioner, to be fully informed about, and responsible for maintaining continuity of, a patient’s medical care. If you are a general practitioner and refer patients to specialists, you should know the range of specialist services available to your patients Referral involves transferring some or all of the responsibility for the patient’s care, usually temporarily and for a particular purpose, such as additional investigation, care or treatment, which falls outside your competence. Usually you will refer patients to another registered medical practitioner. If this is not the case, you must be satisfied that such health care workers are accountable to a statutory regulatory body, and that a registered medical practitioner, usually a general practitioner, retains overall responsibility for the management of the patient. When you refer a patient, you should provide all relevant information about the patient’s history and current condition. Specialists who have seen or treated a patient should, unless the patient objects, tell the general practitioner the results of the investigations, the treatment provided and any other information necessary for the continuing care of the patient.

GMC Good Medical Practice, paragraphs 2.4, 38, 40, 41

The excellent GP
- can, within his or her team, provide the types of care usually provided by GPs
- makes appropriate judgements about patients who need referral
- chooses specialists to meet the needs of individual patients
- accompanies referrals with the information needed by the specialist to make an appropriate and efficient evaluation of the patient's problem
- where appropriate, feeds back to specialists views on the quality of their care

The unacceptable GP
- does not refer patients when specialist care is necessary
- consistently refers patients for care which would normally be regarded as part of general practice
- does not provide information in a referral that enables the specialist to give appropriate care