ASF Standards · Primary Health Clinic · Standard 5
Standard 5 — Referral & Care Coordination
Criteria in this standard
5.1 — Every Referral Is Tracked to Actual Completion, Not Assumed to Have Happened
5.2 — Specialist Findings Return to the Referring Clinician Within a Defined Timeframe
5.3 — Responsibility for Follow-Up Is Explicitly Assigned, Not Left Ambiguous
5.4 — A Genuinely Urgent Referral Is Tracked With Greater Urgency Than a Routine One
5.5 — The Patient Is Actively Supported Through the Referral Process, Not Left to Navigate It Alone
5.2 — Specialist Findings Return to the Referring Clinician Within a Defined Timeframe
5.3 — Responsibility for Follow-Up Is Explicitly Assigned, Not Left Ambiguous
5.4 — A Genuinely Urgent Referral Is Tracked With Greater Urgency Than a Routine One
5.5 — The Patient Is Actively Supported Through the Referral Process, Not Left to Navigate It Alone
5.1
Every Referral Is Tracked to Actual Completion, Not Assumed to Have Happened
Non-Negotiable
Every specialist referral is actively tracked from the point it's sent through to a documented, completed appointment — not assumed to have happened simply because the referral was made, with no active follow-up to confirm the patient was actually seen.
In plain terms: Every referral to a specialist is tracked until the appointment has actually happened — not assumed to have happened because the letter was sent.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | Adapted | Full | Adapted | Full |
Why this matters
This is the PHC version of ambulatory 4.8, and in primary care the volume is higher and the consequences equally grave. The referral for the breast lump, the suspicious mole, the rectal bleeding — if it does not arrive, or the patient does not go, or the specialist does not see them, the cancer grows in the gap. Tracking means a log from referral sent to appointment confirmed to patient attended, checked at intervals, with a chase for anything not confirmed. A practice that sends referrals and forgets them has an unknown number of patients in limbo.
What good looks like
- Every referral is genuinely tracked through to documented completion.
- A specific process identifies referrals that haven't completed within an expected timeframe.
- Genuine follow-up action resolves identified gaps, not just notes them.
Common failure modes
- Referrals are assumed complete once sent, with no active tracking.
- No process identifies referrals that have stalled or failed to complete.
- Incomplete referrals are recognized but not actively resolved.
Worked example
In practice
A 6-room health centre sending 150 referrals a month.
BeforeReferrals were sent by letter or electronic system. No log. The Coordinator sampled 40 referrals from three months earlier: 13 had no record of an appointment at the receiving facility; 4 were urgent (two suspected cancers). The practice had not known.
ActionA referral log was built in the EHR: every referral entered with urgency and expected appointment timeframe; the practice nurse reviews it weekly; any referral without appointment confirmation by the expected date is chased with the receiving facility and the patient; outcomes recorded. Urgent referrals are confirmed by phone within 7 days.
AfterThe Monitor reviewed four months of the log: 600 referrals, 96% confirmed attended; 18 recovered by chasing. Verified.
If you are starting from zero — do this first
- Sample 30 referrals from three months ago. Phone the receiving facility: was the patient seen?
- Build a referral log with expected dates.
- Review weekly and chase anything unconfirmed.
- Phone-confirm urgent referrals within 7 days.
The most common mistake: Treating the referral as complete when the letter leaves the building.
Self-assessment questions
1. Is every referral actively tracked from the point it's sent through to a documented, completed appointment? — Real, active tracking to actual completion, not assumed follow-through.
Evidence: Referral tracking record
Evidence: Referral tracking record
2. Is there a specific process for identifying a referral that hasn't resulted in a completed appointment within an expected timeframe? — A real, active identification process, not passive hope the referral was completed.
Evidence: Incomplete referral identification process
Evidence: Incomplete referral identification process
3. When an incomplete referral is identified, is there a genuine follow-up action, not just awareness the gap exists? — Real, active follow-up, not a gap noted without resolution.
Evidence: Follow-up action record
Evidence: Follow-up action record
Common reasons for a PARTIAL answer
- Tracking exists for referrals to some specialties but not consistently across all specialty types. — Every referral, regardless of specialty, carries the same real risk of falling through without active tracking.
- Incomplete referrals are identified but the expected timeframe for follow-up varies inconsistently. — A consistent, defined timeframe is what makes identification genuinely reliable, not left to individual judgement.
- Follow-up happens once but isn't repeated if the initial attempt doesn't resolve the gap.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current referral practice for genuine tracking versus assumed completion. |
| Week 2 | Establish a systematic tracking process covering every referral to actual documented completion. |
| Week 3 | Define a specific timeframe and process for identifying incomplete referrals. |
| Ongoing | Track referral completion rates and follow up on identified gaps until resolved. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Tracking system review | Reviews the referral tracking system for genuine tracking to actual completion, not assumed follow-through. |
| DOCUMENT | Incomplete referral identification review | Reviews the process for identifying referrals that haven't resulted in a completed appointment. |
| DOCUMENT | Follow-up action review | Reviews evidence of genuine follow-up action when an incomplete referral is identified. |
Supervisor tips
- Ask for the practice's actual, current referral completion rate, not a general impression. — A specific, real number reveals genuine tracking, not an assumption of adequacy.
- Ask for a real, recent example of an incomplete referral and what happened next. — A real, traceable example reveals whether tracking genuinely leads to resolution, not just identification.
Evidence base
[21] An analysis of over 100,000 referral scheduling attempts in a large health system found only 34.8 percent resulted in documented completed specialist appointments, establishing active tracking to completion, distinct from assumed follow-through, as essential to closing the referral loop.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
5.2
Specialist Findings Return to the Referring Clinician Within a Defined Timeframe
Non-Negotiable
Specialist consultation notes and findings are returned to the referring clinician within a specific, defined timeframe, actively confirmed as received — not left to arrive whenever they happen to, or lost entirely in an unreviewed pile of incoming correspondence.
In plain terms: The specialist's findings come back to the referring doctor within a set time — and the practice chases them if they do not.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | Adapted | Full | Adapted | Full |
Why this matters
The patient saw the cardiologist. What did the cardiologist find? What did they change? Is the patient on a new medication that interacts with the one the GP prescribed? If the specialist letter does not arrive, or arrives three months later, the referring doctor manages the patient blind. A defined timeframe — two weeks for routine, 48 hours for urgent — with a chase for anything overdue, closes the loop. The referral log (5.1) can track this: appointment confirmed → letter received → letter reviewed. A practice that does not track return of findings does not know what its specialists have done to its patients.
What good looks like
- A specific, defined timeframe governs when specialist findings should return.
- Receipt is actively confirmed, not assumed.
- A real follow-up process addresses findings that don't arrive as expected.
Common failure modes
- No specific timeframe exists; findings arrive whenever they happen to.
- Receipt is assumed unless a problem becomes obvious.
- No follow-up occurs when expected findings don't arrive.
Worked example
In practice
A 5-room health centre with referrals tracked to appointment (5.1) but not to findings.
BeforeSpecialist letters arrived by post when they arrived. The Coordinator found 30 patients whose specialist appointments had been confirmed but whose letters had not been received two months later. In three cases, medications had been changed by the specialist without the practice knowing.
ActionThe referral log was extended: after appointment confirmation, a 'findings received' date with an expected timeframe (14 days routine, 2 days urgent). The nurse chases any overdue letter with the receiving facility. Received letters are flagged for the referring clinician's review within 48 hours and medication changes are reconciled.
AfterThe Monitor reviewed three months of the extended log: 92% of findings received within timeframe; 25 chased and obtained; all reviewed with medication reconciliation where relevant. Verified.
If you are starting from zero — do this first
- From your referral log, list confirmed appointments with no specialist letter received.
- Set a timeframe: 14 days routine, 2 days urgent.
- Chase every overdue letter.
- Reconcile medications from every specialist letter.
The most common mistake: Assuming the specialist will write — many do, eventually; the ones who do not leave the patient's GP in the dark.
Self-assessment questions
1. Are specialist findings returned to the referring clinician within a specific, defined timeframe? — A real, specific timeframe, not an open-ended expectation of eventual return.
Evidence: Specialist return timeframe documentation
Evidence: Specialist return timeframe documentation
2. Is receipt of specialist findings actively confirmed, not assumed if nothing seems to go wrong? — Genuine, active confirmation, not passive assumption of receipt.
Evidence: Receipt confirmation record
Evidence: Receipt confirmation record
3. Is there a specific process for following up when specialist findings don't arrive within the expected timeframe? — A real, active follow-up process, not findings simply waited for indefinitely.
Evidence: Missing findings follow-up process
Evidence: Missing findings follow-up process
Common reasons for a PARTIAL answer
- A timeframe exists but isn't consistently communicated to the specialist practices being referred to. — A timeframe the specialist practice doesn't know about is unlikely to be genuinely honored.
- Findings that do arrive are reviewed promptly but incoming correspondence isn't systematically checked for what's missing. — Genuine tracking requires actively noticing what hasn't arrived, not just processing what has.
- Follow-up happens for referrals the clinician specifically remembers but not systematically across all pending referrals.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current practice for a specific, defined return timeframe for specialist findings. |
| Week 2 | Communicate the expected timeframe to specialist practices and establish receipt confirmation. |
| Week 3 | Build a systematic process for identifying and following up on missing findings. |
| Ongoing | Track findings receipt against the defined timeframe. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Timeframe definition review | Reviews whether a specific, defined timeframe exists for specialist findings to return. |
| DOCUMENT | Receipt confirmation review | Reviews evidence that receipt of specialist findings is actively confirmed, not assumed. |
| DOCUMENT | Missing findings follow-up review | Reviews the process for following up when findings don't arrive as expected. |
Supervisor tips
- Ask for the specific, defined timeframe the practice expects specialist findings within. — A specific, real answer reveals a genuine standard, not an open-ended expectation.
- Ask how the practice would know if specialist findings for a specific referral never arrived. — A specific, confident answer reveals genuine systematic tracking, not reliance on individual memory.
Evidence base
[22] Institute for Healthcare Improvement, National Patient Safety Foundation. Closing the Loop: A Guide to Safer Ambulatory Referrals in the EHR Era. Cambridge, MA: IHI; 2017 — establishes a standardized, nine-step closed-loop process requiring specialist findings to be communicated back to the referring clinician through appropriate channels within a defined timeframe.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
5.3
Responsibility for Follow-Up Is Explicitly Assigned, Not Left Ambiguous
Non-Negotiable
At every stage of the referral process, one specific person or role is explicitly responsible for the next step — not left as shared or assumed responsibility that, in practice, no one specifically owns.
In plain terms: At every step of a referral — sending, confirming, receiving findings, follow-up — one named person or role is responsible, so nothing is 'someone else's job.'
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Adapted | Full |
Why this matters
Referrals fail in the gaps between people: the doctor sent it, the receptionist filed it, the nurse assumed the doctor would chase it, the doctor assumed the receptionist would. Explicit assignment — 'the referral coordinator confirms appointments; the referring clinician reviews findings; the practice nurse chases overdue items' — closes the gaps. It is written in the referral process, known by everyone, and visible in the log. When something goes wrong, the question 'whose job was it?' has an answer.
What good looks like
- Specific, explicit responsibility is assigned at every referral stage.
- Staff can confidently, consistently identify who owns each stage.
- Assignment is genuinely kept current as staff and roles change.
Common failure modes
- Responsibility is shared or assumed, with no specific ownership.
- Staff give inconsistent or uncertain answers about who is responsible.
- Assignment structure is outdated, not reflecting who actually does the work.
Worked example
In practice
A 6-room health centre with a referral process everyone thought someone else owned.
BeforeWhen a referral was lost, the doctor said reception should have sent it; reception said the doctor should have checked; the nurse said it was not her role. The process had steps but no owners. Referrals fell between them regularly.
ActionThe referral process was documented with a named role at every step: referring clinician (creates and reviews findings), referral coordinator (sends, confirms appointment, chases), practice nurse (reviews overdue log weekly, contacts patients), practice manager (monthly audit). The roles are printed on the process sheet and in the log headers.
AfterThe Monitor reviewed the process document with named roles, the log showing each step's owner, and interviewed the referral coordinator who described her responsibilities precisely. Verified.
If you are starting from zero — do this first
- Ask three staff who is responsible for chasing an unconfirmed referral. If the answers differ, that is the gap.
- Write the referral process with one named role per step.
- Print it and put it where the work happens.
- Add the owner to each column of the log.
The most common mistake: Shared responsibility — when everyone is responsible, no one is.
Self-assessment questions
1. Is one specific person or role explicitly responsible for each stage of the referral process? — Real, specific, named responsibility, not shared or assumed ownership.
Evidence: Referral process role assignment documentation
Evidence: Referral process role assignment documentation
2. Can any staff member correctly identify who is responsible for a specific stage, without hesitation? — Genuine, confident, consistent knowledge, not uncertainty about who owns a given step.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
3. When responsibility changes — staff turnover, role changes — is the assignment genuinely updated, not left stale? — Real, maintained assignment, not an outdated structure that no longer reflects who actually does the work.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
Common reasons for a PARTIAL answer
- Responsibility is clearly assigned for the initial referral but less clear for the follow-up tracking stage. — Every stage of the process, not only the initial step, needs the same explicit ownership.
- Assignment exists on paper but staff describe genuine uncertainty in daily practice. — A documented assignment that isn't genuinely understood in practice provides limited real protection.
- Assignment was accurate at one point but hasn't been updated following recent staff changes.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current referral process for genuine, specific responsibility assignment at each stage. |
| Week 2 | Establish explicit, named ownership for every stage, including follow-up tracking. |
| Week 3 | Brief all relevant staff on the current, specific assignment structure. |
| Ongoing | Update assignment promptly whenever staff or roles change. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Role assignment review | Reviews documentation for specific, explicit responsibility assignment at each referral stage. |
| ASK | Responsibility identification interview | Asks multiple staff members to identify who is responsible for a specific referral stage. |
| DOCUMENT | Assignment currency review | Reviews whether responsibility assignment is genuinely updated as staff or roles change. |
Supervisor tips
- Ask two different staff members who is responsible for the same specific referral stage. — Consistent, confident answers reveal genuine clarity; inconsistent answers reveal ambiguity.
- Ask how responsibility assignment was updated after the most recent staff change. — A specific, real answer reveals whether the structure is genuinely maintained, not left stale.
Evidence base
[23] Research into primary care and specialist referral handoffs identifies ambiguous responsibility for coordinating patient care as a specific, documented area of breakdown, distinct from individual clinician failure, arising when no single role is explicitly assigned ownership of a given step.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
5.4
A Genuinely Urgent Referral Is Tracked With Greater Urgency Than a Routine One
Non-Negotiable
A referral for a genuinely urgent clinical concern is tracked and followed up with meaningfully greater urgency than a routine referral — not placed into the same tracking process and timeframe as any other referral, regardless of the underlying concern's real clinical significance.
In plain terms: An urgent referral — suspected cancer, a serious finding — is tracked and chased faster and harder than a routine one, with shorter clocks and phone confirmation.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Full | Full |
Why this matters
A referral for a suspected melanoma and a referral for a routine hernia repair should not sit in the same queue with the same follow-up. The urgent one has a two-week clock (or whatever the national standard is); it must be confirmed received, confirmed booked, confirmed attended — by phone, not by waiting for a letter. If it is not booked within the standard, it is escalated. The routine referral can wait for the monthly check. A practice that treats all referrals the same is treating the urgent ones too slowly.
What good looks like
- Urgent referrals genuinely receive more intensive tracking than routine ones.
- Urgency is explicitly, clearly communicated to the receiving specialist.
- A genuinely shorter timeframe governs identification of incomplete urgent referrals.
Common failure modes
- Every referral is tracked identically, regardless of clinical urgency.
- Urgency is left for the specialist to infer, not explicitly communicated.
- The same timeframe applies to urgent and routine referrals alike.
Worked example
In practice
A 5-room health centre with a single referral log and monthly review.
BeforeAll referrals were reviewed monthly. An urgent suspected cancer referral was sent, not confirmed, and picked up at the monthly review five weeks later — the patient had not been seen. Urgency was noted on the referral but did not change the tracking.
ActionThe referral log was split by urgency. Urgent referrals: phone confirmation of receipt within 2 working days, appointment confirmed within 7 days, attended confirmed within 14 days; any breach escalated to the referring clinician and the receiving facility's referral lead the same day. Routine referrals: monthly review. The nurse checks the urgent list daily.
AfterThe Monitor reviewed three months of urgent referrals: 45 sent, all confirmed within 2 days, 43 seen within 14 days, 2 escalated and resolved. Verified.
If you are starting from zero — do this first
- Pull your last ten urgent referrals: how long from sending to confirmed appointment?
- Split the log by urgency.
- Set short clocks for urgent: 2 days, 7 days, 14 days.
- Check the urgent list daily.
The most common mistake: Marking a referral 'urgent' and tracking it on the same monthly cycle as everything else.
Self-assessment questions
1. Is a genuinely urgent referral tracked with meaningfully greater urgency than a routine one? — A real, differentiated process, not identical tracking regardless of clinical significance.
Evidence: Urgency-differentiated tracking documentation
Evidence: Urgency-differentiated tracking documentation
2. Is urgency specifically communicated to the receiving specialist, not left for them to infer? — Explicit, clear urgency communication, not an assumption the specialist will recognise it independently.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
3. Is there a specific, shorter timeframe for identifying an incomplete urgent referral, distinct from routine referrals? — A genuinely shorter, specific timeframe, not the same interval applied to every referral.
Evidence: Urgent referral timeframe documentation
Evidence: Urgent referral timeframe documentation
Common reasons for a PARTIAL answer
- Urgency is communicated verbally but not consistently documented in the referral itself. — Documented urgency is more reliable than a verbal mention that may not reach everyone involved in processing the referral.
- A shorter timeframe exists for urgent referrals but isn't consistently applied in daily practice. — A defined timeframe needs consistent application to provide genuine, reliable protection.
- Urgency differentiation is clear for obviously urgent cases but less consistent for moderately time-sensitive ones.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current referral tracking for genuine urgency differentiation. |
| Week 2 | Establish explicit urgency communication and documentation for time-sensitive referrals. |
| Week 3 | Define a genuinely shorter identification timeframe for urgent referrals. |
| Ongoing | Audit urgent referral tracking specifically for consistent, meaningful differentiation. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Differentiated tracking review | Reviews whether urgent referrals genuinely receive more intensive tracking than routine ones. |
| OBSERVE | Urgency communication observation | Observes whether urgency is explicitly, clearly communicated to the receiving specialist. |
| DOCUMENT | Urgent timeframe review | Reviews whether a genuinely shorter identification timeframe applies to urgent referrals. |
Supervisor tips
- Ask for a real, recent example of an urgent referral and how its tracking genuinely differed from a routine one. — A real, specific comparison reveals whether differentiation is genuine practice, not just policy language.
- Ask how urgency is actually communicated to a receiving specialist for a specific referral. — A specific, confident answer reveals genuine, explicit communication, not an assumption it's understood.
Evidence base
[24] High variation in specialist wait times, correlated with lower documented appointment completion rates, is identified in referral system research, establishing that urgency-differentiated tracking, not uniform process application, is necessary to protect genuinely time-sensitive referrals.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
5.5
The Patient Is Actively Supported Through the Referral Process, Not Left to Navigate It Alone
Core
The patient receives genuine, active support navigating the referral process — clear information about what to expect, help scheduling where needed, someone to contact with questions — not handed a referral and left entirely responsible for making it happen themselves.
In plain terms: The patient is actively helped through the referral — told what to expect, helped to book, reminded, checked on afterward — not handed a letter and left to manage it alone.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Adapted | Full |
Why this matters
'Here is a referral letter, the hospital will contact you' is the start of a process the patient does not understand. Which hospital? When? What happens there? What if they do not call? Patients who are anxious, elderly, non-native speakers, or in unstable circumstances are the least able to navigate — and the most likely to need the referral. Support means: a plain-language explanation of what the referral is for and what will happen; help booking where the patient must book; a reminder before the appointment; a check afterward. The referral coordinator (5.3) can do this; it is what makes the referral real for the patient.
What good looks like
- Patients receive genuine, active support through the referral process.
- A specific, known contact exists for patient questions or difficulties.
- Genuine follow-up occurs when initial contact doesn't result in scheduling.
Common failure modes
- Patients are handed a referral and left entirely responsible for the rest.
- No specific contact exists for patient questions during the process.
- The process ends after one contact attempt, regardless of whether scheduling occurred.
Worked example
In practice
A 6-room health centre serving an elderly and multilingual population.
BeforeReferral letters were handed over with 'they'll contact you.' Non-attendance at specialist appointments was 30%. Interviewed patients said they did not know what the referral was for, had not understood the appointment letter, or had no transport.
ActionThe referral coordinator now explains every referral in plain language (or via interpreter), gives a printed sheet ('You are being referred to X for Y; they will contact you by Z; if not, call us'), books the appointment with the patient where self-booking is required, sends a reminder two days before, and phones after to check attendance and understanding. Transport assistance is arranged for those who need it.
AfterThe Monitor reviewed 30 referrals with documented explanation, reminders, and post-attendance check. Non-attendance fell from 30% to 11%. Interviewed a patient who described the support. Verified.
If you are starting from zero — do this first
- Ask five recently referred patients what they were referred for and what happens next.
- Create a plain-language referral sheet.
- Send a reminder two days before every specialist appointment.
- Phone afterward to confirm attendance and understanding.
The most common mistake: Assuming the patient can navigate the health system as well as you can.
Self-assessment questions
1. Does the patient receive genuine, active support navigating the referral process, not just a referral handed over? — Real, active support, not the patient left entirely responsible for making the referral happen.
Evidence: Patient referral support documentation
Evidence: Patient referral support documentation
2. Is there a specific person the patient can contact with questions or difficulties during the referral process? — A real, known contact, not an assumption the patient will figure out who to ask.
Evidence: Patient support contact information
Evidence: Patient support contact information
3. Is there genuine follow-up with the patient if an initial specialist contact attempt doesn't result in scheduling? — Real, active follow-up at exactly the most common failure point, not the process ending after one attempt.
Evidence: Patient follow-up record
Evidence: Patient follow-up record
Common reasons for a PARTIAL answer
- Support is offered proactively for complex referrals but less consistently for ones assumed to be straightforward. — Any referral can genuinely stall at the contact-to-scheduling gap, not only complex ones.
- A contact exists but isn't clearly communicated to the patient at the time of referral. — A contact the patient doesn't know about provides limited real support when they actually need it.
- Follow-up happens once after a failed contact attempt but isn't repeated if that follow-up also doesn't succeed.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current patient support through the referral process, particularly at the contact-to-scheduling stage. |
| Week 2 | Establish a clear, communicated contact for patient questions and difficulties. |
| Week 3 | Build genuine follow-up practice for patients not successfully scheduled after initial contact. |
| Ongoing | Track patient scheduling success specifically at this identified common failure point. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Patient support review | Reviews evidence of genuine, active patient support through the referral process. |
| ASK | Patient contact interview | Asks a patient whether they know who to contact with referral questions or difficulties. |
| DOCUMENT | Scheduling follow-up review | Reviews whether genuine follow-up occurs when initial contact doesn't result in scheduling. |
Supervisor tips
- Ask a patient currently navigating a referral whether they know who to contact with questions. — A confident, specific answer reveals genuine, known support, not an assumed pathway.
- Ask what happens when a specialist's office can't reach a patient on the first attempt. — A specific, real answer reveals whether follow-up genuinely happens at this common failure point.
Evidence base
[25] Research into referral process breakdowns identifies the gap between initial patient contact and actual appointment scheduling as the most common failure point, establishing active patient support through this specific stage as necessary to prevent referrals from being lost.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.