|The doctor refers the patient inappropriately. The referral letter is unclear and the doctor makes little attempt to keep the hospital informed of the patients change in condition.
||The doctor having obtained all the necessary information refers appropriately. He/she involves the patient in this decision. A clear referral letter is written and the doctor keeps the hospital up to date with changes in the patient’s circumstances after the initial referral.
|Has little understanding of this.
||Attempts to do this but is not yet skilful and sometimes runs into difficulty.
||Attempts to do this and is usually successful but recognises his/her limitations.
||Clearly defines problems and management dilemmas.
||Informs patient as to the need for referral and likely outcome.
||Decides urgency of appointment .
||Referral letter includes significant past medical history and regular medications.
||Informs hospital of any major change in condition/ alteration in medication.
Notes for raters
This area of behaviour can be assessed by record review and case discussion.