Intended for healthcare professionals


Defending referrals between consultants

BMJ 2006; 332 doi: (Published 09 February 2006) Cite this as: BMJ 2006;332:371

Rising to the defence

Dear Sir

Dr Goodman's article is timely. Just today a consultant at my local
hospital insisted on speaking with me about a case which was felt needed
urgent attention by another department in the same hospital. [Patient and
doctor confidentiality preclude me from being too specific]. My PCT
(Watford & Three Rivers PCT) has apparently recently decreed that
there should be no consultant to consultant referrals forthwith, except in
the case of suspected cancer.

This is NOT anecdotal - it is happening on my doorstep, and probably
yours too (If you work in the UK).

In my opinion this is inefficient and does not seem ethical.
Certainly, my patient needs an outpatient appointment this week and not
wait until April 2006 which is the earliest 'urgent' appointment that I
was able to manage even with telephoning the secretary and faxing my
referral. Thankfully, the first consultant has managed to get the needed
urgent appointment, but only after speaking with me and haggling with the
second team.

There has been no forewarning of this new state of affairs; the PCT
did not see fit to write to local GPs about this issue at all. We have
not had a chance to discuss it or lobby for something different, if not
preserve the status quo. If ever there was an example of how managers
with no clinical knowledge can wield so much power over the fate and
wellbeing of the population this is it. The Public should know and demand
that this silliness stops.

Competing interests:
I am a GP who is directly affected by this issue

Competing interests: No competing interests

15 February 2006
David M Lewis
General Practitioner
The Tudor Surgery, Watford WD24 7PH, UK