Sources and types of referral to a haematology department.
An audit was undertaken of the case notes of all new outpatients referred to the haematology department at the Leeds General Infirmary over a one-year period. The source, reason for referral, final diagnosis and outcome were determined in each case, along with essential biographical details. The results show that general practitioners initiated over half of all referrals, often prompted by written comments from a hematologist on a full blood count advising them that further tests were required. Almost a third came from other departments at the study hospital and the remainder originated from hospitals outside the district. Most general practitioner referrals were made with a request for a diagnosis. Hospital initiated referrals were more likely to have a final diagnosis of a malignant haematological disease, whereas those from general practice tended to have benign or self-limiting conditions. Ninety-one per cent of patients referred had an abnormality. There were low numbers of both clinic defaulters and those patients required to be re-referred to other specialties. These results suggest that the high quality of referrals is largely due to the general practitioner's decision to refer patients based on the full blood count result. This often occurs after discussion with haematology medical staff. The possible impact of the government's White Paper proposals on this outpatient service is discussed.
Leeds General Infirmary.
D
D
Wright
G
G
Smith
D
D
Norfolk
A
A
Child
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004739:England / Q000453:epidemiology; D005260:Female; D006402:Hematologic Diseases / Q000453:epidemiology*; D006405:Hematology / Q000706:statistics & numerical data*; D006748:Hospital Departments / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013222:State Medicine / Q000706:statistics & numerical data; D014600:Utilization Review