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Referrals from the community to the hospital eye service

Pooley, J. E. (1996). Referrals from the community to the hospital eye service. (Unpublished Doctoral thesis, City, University of London)


Ophthalmic referrals to the outpatient (OPD) and accident and emergency departments (AED) of Moorfields Eye Hospital, London and the OPD of the Birmingham and Midland Eye Hospital were examined. Referral correspondence was analysed and Practitioners and Patients were questioned.

Over half the referrals to the OPD and three quarters AED referrals were generated by the patient’s GP. The GP refers over 80% external eye conditions and about 50% cataract referrals received. Many GP referrals to AED were an inappropriate use of the emergency service.

Almost all routine community referrals were sent via the patient’s GP. The added value of referring via the GP is low. This is acknowledged by GPs who frequently find onward referral an administrative burden. 96.8% GPs questioned felt some patients would benefit from direct referral. Only about 50% GPs add any information to the OO/OMP’s referral of which only 25% give important general medical information. Up to 22% GPs did not include the initiating Ophthalmic Practitioners correspondence when forwarding the referral to the HES.

Ophthalmic practitioners referred over 80% glaucoma suspects. Their accuracy was not high with less than 50% glaucoma referrals being confirmed or high risk cases. Accuracy was higher when intra-ocular pressures were higher, when there was a greater difference in pressure between each eye, and when the patient was older.

New younger asymptomatic patients were less likely to attend their outpatients appointment. The main reasons were that the patient claimed to have already cancelled the appointment (25%) or that he/she had not received the appointment notification (16%). The likelihood of failing to attend was not related to the referral process.

Publication Type: Thesis (Doctoral)
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RE Ophthalmology
Departments: School of Health & Psychological Sciences > Optometry & Visual Sciences
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
Doctoral Theses
[thumbnail of Pooley thesis 1996 PDF-A.pdf]
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