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BMJ. 1992 March 28; 304(6830): 821–824.
PMCID: PMC1881665

Communication between general practitioners and consultants: what should their letters contain?


OBJECTIVE--To canvass the views of all general practitioners and consultants working in Newcastle upon Tyne on the content of referral letters and replies, the feasibility of standardising certain aspects of referral letters, and the use of communications data for audit purposes. DESIGN--A postal questionnaire was sent to all general practitioners and consultants in Newcastle upon Tyne in May 1991. Questions were asked about the clinical and administrative content of letters, the utility of standard categories to state the reason for referral, the idea of using letters for feedback purposes, and communications as a potential topic for professionally led audit. SETTING--Area served by Newcastle upon Tyne Family Health Services Authority and District Health Authority. RESULTS--Replies were received from 274 (77%) doctors (115 general practitioners and 159 consultants). A majority (225; 82%) were in favour of items defined as "always important" forming a minimum requirement for referral letters and for consultants' replies. Using standardised categories to state the reason for referral was not endorsed: 102 (89%) general practitioners and 132 (83%) consultants preferred referrers to use their own words. Using referral communications to provide feedback was less popular with consultants (54; 34%) than general practitioners (72; 63%). Finally, a majority of doctors (179; 65%) were in favour of using written communications as a topic for professionally led audit. CONCLUSIONS--A high degree of consensus exists among clinicians about the content of referral communications. Although doctors may still reject the concept of standardised communications, they have unambiguously endorsed a standard for communication that they can aspire to, and they are prepared to use it as a yardstick for their actual performance.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Westerman RF, Hull FM, Bezemer PD, Gort G. A study of communication between general practitioners and specialists. Br J Gen Pract. 1990 Nov;40(340):445–449. [PMC free article] [PubMed]
  • Doeleman F. Improving communication between general practitioners and specialists. Fam Pract. 1987 Sep;4(3):176–182. [PubMed]
  • Leonard I, Babbs C, Creed F. Psychiatric referrals within the hospital--the communication process. J R Soc Med. 1990 Apr;83(4):241–244. [PMC free article] [PubMed]
  • Roland MO, Porter RW, Matthews JG, Redden JF, Simonds GW, Bewley B. Improving care: a study of orthopaedic outpatient referrals. BMJ. 1991 May 11;302(6785):1124–1128. [PMC free article] [PubMed]
  • Marinker M, Wilkin D, Metcalfe DH. Referral to hospital: can we do better? BMJ. 1988 Aug 13;297(6646):461–464. [PMC free article] [PubMed]
  • Young DW, Parkes J, Davis WA, Harman D, Williams RS. Out-patient letters: requirement and contents. Eff Health Care. 1985;2(6):225–229. [PubMed]
  • Kentish R, Jenkins P, Lask B. Study of written communication between general practitioners and departments of child psychiatry. J R Coll Gen Pract. 1987 Apr;37(297):162–163. [PMC free article] [PubMed]
  • Scaffardi RA. Study of written communication between general practitioners and a community physiotherapist. J R Coll Gen Pract. 1989 Sep;39(326):375–376. [PMC free article] [PubMed]

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