Monitoring of general practitioners' outpatient referral rates by Family Health Services Authorities: how practical?

The Government proposes that Family Health Services Authorities should monitor general practitioner referral rates, although the information available to them might be inadequate for the task. This study was undertaken to assess the difficulties Family Health Services Authorities could face when monitoring referrals using rates related to doctors' list size. This paper describes an investigation into this problem which analysed all outpatient referrals from one general practice from 1984 to 1988. Referral rates showed important variations between calendar quarter recording periods, and rates based on list size were inaccurate compared with those based on consultations. Proportions of obstetric, gynaecological and private referrals varied widely between the doctors. These findings suggest that monitoring of referral rates by Family Health Services Authorities will be relatively crude, and can only be improved by the full cooperation of general practitioners.