Quality of Referrals

11 Quality of referrals


11.1 Delays, inadequate information provided within referral correspondence and unnecessary referrals are not beneficial to the clinical care of patients.  While some members from all professions are sending high quality correspondence with all the relevant information and results enclosed, others fall below what should be considered acceptable standards.


11.2 A good referral should contain the following


  • Date
  • Full name of referring optometrist and practice address in block letters
  • Full details of patient including name, address, telephone number, date of birth, NHS number (where known), reason for referral, supporting signs and symptoms, reports of relevant tests / investigations, include copies of any supplementary data e.g. field plots.
  • Family history
  • Provisional diagnosis
  • Current medication
  • Indication of urgency


Referral correspondence, whether GOS 18 or letter, should be legible and preferably typed or word processed.


An electronic copy of all referral forms used in Birmingham can be obtained by clicking the forms link on the home page.  These can be completed on your computer then either printed and faxed or attached to an email and sent via nhs.net mail


All referral reports, whether GOS18 or letter, should indicate the degree of urgency/ priority, if they are for information only, this should be clearly stated.


11.3 In some areas local protocols have been established to facilitate referral refinement by accredited optometrists.  Optometrists involved in such schemes on either side of the process must be aware of the ethical position vis-à-vis the patient and colleagues. In all instances the terms of reference for such protocols should act to enhance and improve referrals at a local level.


11.4 It is essential to be able to audit referrals so that the value to patients can be measured over the range of referrals, not simply on a case by case basis.  This means setting up appropriate recording systems within the practice to make sure that the information is kept centrally as well as on individual patient records.  Feedback from ophthalmologists is pivotal to the audit process and it is hoped that this will become the norm with optometrists taking on the role of primary referrer.