A registrar survival guide... how to write a referral letter

In these times of austerity, we are all compelled to think hard about whether our referrals are necessary.

Many practices have meetings to discuss alternative pathways of patient care, which are then fed back to the PCT.

Assuming a referral is required, having a clear purpose and question in mind will inform the content of your letter.

Know your audience
With time, you will learn what information is preferred by each specialty, including which investigations to carry out beforehand.

I include the most pertinent details in the main letter, with an attached summary printout of the medical history and current medications.

Know your patient
It is important to convey the patient's understanding of their condition and its impact on their life, within the context of their social background. It is also useful to state the patient's agenda. A specialist opinion about a particular procedure is a valid reason to refer.

Know your spelling and grammar
I summarise the purpose of a letter in its first sentence. Using words such as 'delightful' to describe your patients is not good practice. Divide your letter into paragraphs and assume that all paragraphs other than the first and last will be ignored.

Know your secretary
Clear dictation is vital. A good secretary will help you in many ways, such as knowing waiting times for various specialties and what constitutes 'soon' or 'urgent'. They may even create a well-structured, grammatically correct and error-free missive.

Essentials checklist
  • An ability to include only the most pertinent information.
  • An understanding of the patient's agenda.
  • Well-structured letter writing.
  • Good spelling and grammar.
  • Dr Suchita Shah is a GP in Oxford

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