A district survey of paediatric outpatient referrals.

A prospective analysis of general paediatric outpatient referrals to a district general hospital was conducted over four months. Because of geographical characteristics, this probably represents all referrals within the district during that time. The referral rate referral rate was 15.5 per thousand per annum. Only five children did not see a consultant at their first visit. One hundred and five children were discharged after one consultation. Communication between general practitioners and hospital appeared generally good. Although only 56 referral letters stated the urgency of referral, 351 (94%) stated a reason for referral. One hundred and five children could have been dealt with by the community child health service. The NHS reforms, fund-holding practices and the development of the community child health service may profoundly affect current outpatient workloads and practice.