Intended for healthcare professionals

Views & Reviews A Consultant’s Take

Referral mismanagement systems

BMJ 2013; 347 doi: (Published 22 November 2013) Cite this as: BMJ 2013;347:f7014
  1. John Dean, consultant cardiologist, Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK
  1. lub.dub{at}

Referral management systems are teams led by general practitioners that aim to improve the efficiency of referrals from primary care to specialists. But the evidence seems clear: they do not improve access; they increase costs; and they preferentially target high referrers, not the worryingly low ones.1

Referral rates to clinics can vary 10-fold between general practitioners working at the same practice. And it drives those of us who work in these clinics nuts. The rapid access chest pain assessment clinic that I help run has clear …

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