title: How urgent is urgent? Analysing urgent out-patient referrals to an adult psychiatric service.
abstract: BACKGROUND
  It was noticed that over some years the number of referrals to the outpatient clinic (from various sources) which were marked 'urgent' had increased. We aimed to examine who makes these urgent referrals and the clinical factors associated with 'urgent' status.
  
  
  METHODS
  A sample of 201 referrals over a 26-month period was examined. Details of the referral requests were collected using a specially designed form. After each 'urgent' assessment, the referral was scored for appropriateness. This gave an indication of the agreement between referrer and clinic doctor as to what should constitute an &#164 urgent' referral.
  
  
  RESULTS
  The majority of urgent referrals were from community psychiatric nurses, who, together with psychiatric social workers, make the most appropriate referrals. The more appropriate referrals clearly specified the clinical factors associated with urgent need for review. Patients regarded as suicidal were not associated with significantly higher appropriateness scores.
  
  
  CONCLUSIONS
  Referrers should try and make 'urgent' outpatient requests as specific as possible: more clinical detail gives a clearer picture to the clinic doctor. Telephone consultations with general practitioners may help to ascertain a clearer picture of urgent requests if detail is lacking. Health professionals may all benefit from education in suicidal risk assessment. ( Int J Psych Clin Pract 2000; 4: 233 - 235).
authors.affiliation: Cefn Coed Hospital, Swansea, UK.
authors.forename: S
authors.initials: S
authors.lastname: Cubbin
authors.forename: S
authors.initials: S
authors.lastname: Llewellyn-Jones
authors.forename: P
authors.initials: P
authors.lastname: Donnelly
keywords: Urgent Outpatient Appointment Community Mental Health Teams Appropriateness General Practitioners