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BMJ. 1988 November 12; 297(6658): 1246–1248.
PMCID: PMC1834740

Referrals to hospital by general practitioners: a study of compliance and communication.


To determine the extent of non-attendance at first hospital appointments 269 hospital referrals made in one practice over 14 weeks were analysed retrospectively. Non-attendance was more likely among patients referred to outpatient departments than to casualty or for admission. Fifteen per cent (41/269) of all patients and 20% (33/167) of outpatients failed to keep their initial appointments. Prolonged waiting times from referral to appointment were significantly related to non-attendance. Twenty weeks after the last referral had been made no communication had been received by the practice for 24% (61/252) of all referral letters received by the hospital. Minimum delays to appointments and improved communication between hospitals and general practitioners would help general practitioners to make appropriate referrals and improve compliance.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Wilkin D, Smith AG. Variation in general practitioners' referral rates to consultants. J R Coll Gen Pract. 1987 Aug;37(301):350–353. [PMC free article] [PubMed]
  • Wilkin D, Smith A. Explaining variation in general practitioner referrals to hospital. Fam Pract. 1987 Sep;4(3):160–169. [PubMed]
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  • Grace JF, Armstrong D. Reasons for referral to hospital: extent of agreement between the perceptions of patients, general practitioners and consultants. Fam Pract. 1986 Sep;3(3):143–147. [PubMed]

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