A Registrar Survival Guide ... Writing a Referral Letter

Contributed by Dr Anna Greenham, a salaried GP in Gateshead

Right patient, right time
There is no such thing as the perfect referral letter. The most important thing is to refer the correct patient to the correct clinic in the correct time frame.

Know the local pathways
Be familiar with local referral pathways and guidelines. This can save a lot of time and bounce backs.

If you are not sure if you should refer, or where to refer to, then ask a more experienced colleague. You can even check with the specialist concerned via email, phone or a message with the relevant secretary.

List reasons for referral
I start off my letter by listing the main reasons for referral, each on a separate line. Keep the history and examination brief and to the point.

Include relevant results
As well as attaching relevant results to the referral I include the most important ones in the text. This can avoid the patient having things repeated unnecessarily, especially when the attachments get lost. Relevant social history can help the consultant deal with the case sensitively (e.g. a traumatised refugee, or difficult social circumstances).

Keep a note of your referrals. That way if the clinic letter does not get returned to you, you can still look up the case for feedback.

Keep the patient informed
Remember not to write anything in the letter that you would not be happy for the patient to read. It can help to dictate the letter in front of the patient and that way they know what is being said.

Make it clear at the end what the patient is hoping from the referral. Also state what questions you would like answered.

Essentials Checklist

  • Familiarity with local referral pathways.
  • Any lab test results.
  • A copy of the referral to keep.


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