Should GPs have direct access to imaging for children with urinary tract infections? An observational study.
BACKGROUND
All children with urinary tract infections (UTIs) should undergo imaging of the urinary tract. The Royal College of Radiologists currently recommends that such children should be referred to a paediatric specialist prior to imaging.


OBJECTIVE
To investigate whether direct referral of such children by general practitioners (GPs) for imaging offers advantages over the traditional approach.


METHODS
Information on 100 children with UTIs, who were referred direct for imaging by GPs according to an agreed protocol, was compared with information on 100 children with UTIs referred initially to paediatric specialists.


RESULTS
Protocol-guided direct referral resulted in less delay prior to imaging, no evidence of inappropriate referral (as judged by urinalysis and yield from imaging), greater consistency of follow-up arrangements, and a considerable saving in outpatient department (OPD) appointments. There was no increase in the overall number of referrals for imaging.


CONCLUSIONS
Given agreed protocols, there is no basis for current recommendations that GPs should not refer children with UTIs for imaging without a prior paediatric opinion.
D000293:Adolescent; D000553:Ambulatory Care / Q000458:organization & administration; D002648:Child; D002675:Child, Preschool; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D012017:Referral and Consultation; D013997:Time Factors; D006113:United Kingdom; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging*