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It is important for the practice to effectively manage referrals
to other health care providers/diagnostics and recalls within your
practice. This assists in promoting optimum opportunity for the
patient to receive appropriate diagnosis, care and treatment.
If you have felt it important to refer a patient to another
practitioner, then you need to be aware of the outcome of that
referral. Developing a tracking system that records referrals and
returned reports will identify any patients who do not present for
appointments with practitioners to whom they have been
A recall system can be utilised to track 'at-risk' patients who
you have asked to return for clinical review.
Download the Referrals & Recalls Checklist
Download the Referrals Tracking Template
You should explain to your patient the reason for a referral and
whether or not it is urgent. This advice should be documented in
the patient record.
Discussion of the patient's expectations of the referral outcome
and arrangements for continuity of care should also take place. As
the referring practitioner, you should include the following as a
minimum in your referral letter:
Determine which referrals will require tracking by
The system you adopt to ensure that patients are followed up
when referred should:
Some of the principles discussed in the previous section on
'test tracking' will assist this process. Please also consider the
Where specialists advise a referring practitioner of a patient's
failure to attend an appointment:
The operation of a recall system is straightforward once a
manual or computerised system is set up. The success of the recall
system is dependent on you flagging the patient for recall during
The mail-outs to recalled patients can be managed by the
practice manager or registered nurse who is responsible for
monitoring the patients who require recalls.
Letters are often printed on a monthly basis and reviewed and
signed by the practitioner before posting.
If you use a manual recall system, you can initiate it by
annotating a stamp on the patient file. The patient's file can then be
forwarded to the staff member responsible for monitoring the manual
recall system who records the recall for the appropriate month in a
Each month is reviewed and recall letters are printed and signed
by the practitioner before sending.
It is important to ensure that you document all attempts to
recall your patients. A copy of each letter sent should be kept on
the patient's file, including whether it was sent by registered
mail. Any telephone contact or messages left should be documented
in the patient's file with the relevant date and time of call, the
name of the person who made the call and any action taken.
It may be convenient to SMS patients who are due for recalls.
However, clinical information should not be included in the SMS.
Patients should provide consent to an SMS recall system.
Patients have the right to not partake in a recall system. The
patient's express wishes to not partake should be documented in the