In-house referral: changing general practitioners' roles in the referral of patients to secondary care.

Innovative approaches to patient management are needed to ensure that only those patients who would benefit most are referred from primary to secondary care. This report describes an exploratory study in which general practitioners adopted the role of reviewing the management of patients who would otherwise be referred to hospital. Patients in eight general practices in South Wales were referred In-house by general practitioners to a colleague in the practice who reviewed the need for hospital care. Qualitative data from interviews and questionnaires is presented. In-house referral appears to be acceptable, practical and of value to both general practitioners and patients.