Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study

Objective Exploring the views of stakeholders to the referral management systems (RMS) used by GP practices in Northumberland, UK to evaluate its perceived effectiveness.Design This was an in-depth qualitative semi-structured interview study.Participants and setting 32 participants (GPs, hospital co...

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Main Authors: Scott Wilkes, Rosie Dew
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/7/e028436.full
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author Scott Wilkes
Rosie Dew
author_facet Scott Wilkes
Rosie Dew
author_sort Scott Wilkes
collection DOAJ
description Objective Exploring the views of stakeholders to the referral management systems (RMS) used by GP practices in Northumberland, UK to evaluate its perceived effectiveness.Design This was an in-depth qualitative semi-structured interview study.Participants and setting 32 participants (GPs, hospital consultants, referral support, hospital managers, Clinical Commissioning Group manager) in the North East of England, UK.Method Interviews using a grounded theory approach and thematic analysis.Results The main benefit of RMS mentioned by participants was that it allowed for unnecessary referrals to be vetted by consultants, and helps ensure patients are sent to the correct clinic. Generally, the consultants in our study felt that RMS did not significantly help them reject referrals. Some GPs experienced that RMS undermined GP autonomy and did not help when they had exhausted their abilities to manage a patient in primary care, and it was suggested that in some cases RMS may delay rather than prevent a referral. The main perceived disadvantage of RMS was the additional workload for GPs and consultants, and RMS was felt to be a barrier to commutation between GPs and consultants. Frustration with the system design and lack of knowledge of its cost-effectiveness were articulated.Conclusion Although RMS was reported to reduce some unnecessary referrals, the effect of referral delay and rejection is unknown. Although there were some positive attributes described, RMS was mostly received negatively by the stakeholders.
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spelling doaj-art-650ee4dd08404bf39ea8db7f3bf2bedf2025-08-20T02:48:43ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2018-028436Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative studyScott Wilkes0Rosie Dew112 School of Medicine, University of Sunderland, Sunderland, UKSchool of Medicine, University of Sunderland, Sunderland, UKObjective Exploring the views of stakeholders to the referral management systems (RMS) used by GP practices in Northumberland, UK to evaluate its perceived effectiveness.Design This was an in-depth qualitative semi-structured interview study.Participants and setting 32 participants (GPs, hospital consultants, referral support, hospital managers, Clinical Commissioning Group manager) in the North East of England, UK.Method Interviews using a grounded theory approach and thematic analysis.Results The main benefit of RMS mentioned by participants was that it allowed for unnecessary referrals to be vetted by consultants, and helps ensure patients are sent to the correct clinic. Generally, the consultants in our study felt that RMS did not significantly help them reject referrals. Some GPs experienced that RMS undermined GP autonomy and did not help when they had exhausted their abilities to manage a patient in primary care, and it was suggested that in some cases RMS may delay rather than prevent a referral. The main perceived disadvantage of RMS was the additional workload for GPs and consultants, and RMS was felt to be a barrier to commutation between GPs and consultants. Frustration with the system design and lack of knowledge of its cost-effectiveness were articulated.Conclusion Although RMS was reported to reduce some unnecessary referrals, the effect of referral delay and rejection is unknown. Although there were some positive attributes described, RMS was mostly received negatively by the stakeholders.https://bmjopen.bmj.com/content/9/7/e028436.full
spellingShingle Scott Wilkes
Rosie Dew
Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
BMJ Open
title Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title_full Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title_fullStr Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title_full_unstemmed Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title_short Evaluation of the referral management systems (RMS) used by GP practices in Northumberland: a qualitative study
title_sort evaluation of the referral management systems rms used by gp practices in northumberland a qualitative study
url https://bmjopen.bmj.com/content/9/7/e028436.full
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