GENERAL-PRACTICE REFERRALS TO A DEPARTMENT OF NEUROLOGY

Objective: Assessment of general practitioner (CP) new referrals to a neurology department in terms of satisfaction for patient and doctor. Design: Prospective study by questionnaire of patients, GPs and specia lists. Setting: Neurology hospital outpatient clinics. Subjects: 339 c onsecutive new outpatients. Main outcome measures: Overall patient sat isfaction with clinic attendance, with allocated time and waiting time s after referral; GPs' reasons for referral, and satisfaction with out come; specialists' actions in the clinic, views on referral. Results: Some 67% of patients found the referral helpful; 23% felt there was in sufficient time to explain fully their problem. Nearly half of the pat ients had waited greater than or equal to 6 months for an appointment, The CP was uncertain of the diagnosis at referral in 76% of cases and found information from the clinic useful in 89%. Specialists made a n ew diagnosis in 40% of referrals, discharged 73% (with or without inve stigation) and admitted 11%; 76% of referrals were felt to be appropri ate. Conclusions: Patients and GPs usually found the referral helpful. Seeing patients more briefly is inappropriate since almost a third al ready felt consultation time to be short. Although some referrals may have been inappropriate, the dominant deficiency in the service was th e time they had to wait after the referral. To satisfy local need, it is estimated that twice the present number of consultant neurologists would be required.