@article{11732,
  author = {Elsa Dinsdale and Ailish Hannigan and Ray O’Connor and Jane O’Doherty and Liam Glynn and Monica Casey and Peter Hayes and Dervla Kelly and Walter Cullen and Andrew O’Regan},
  title = {Communication between primary and secondary care: deficits and danger},
  abstract = {<jats:title>Abstract</jats:title>
               <jats:sec>
                  <jats:title>Background</jats:title>
                  <jats:p>Timely and accurate communication between primary and secondary care is essential for delivering high-quality patient care.</jats:p>
               </jats:sec>
               <jats:sec>
                  <jats:title>Objective</jats:title>
                  <jats:p>The aim of this study is to evaluate the content contained in both referral and response letters between primary and secondary care and measure this against the recommended national guidelines.</jats:p>
               </jats:sec>
               <jats:sec>
                  <jats:title>Methods</jats:title>
                  <jats:p>Using an observational design, senior medical students and their general practice supervisors applied practice management software to identify 100 randomly selected adults, aged greater than 50 years, from a generated list of consults over a 2-year period (2013–2015). All data included in referral and response letters for these adults were examined and compared with the gold standard templates that were informed by international guidelines.</jats:p>
               </jats:sec>
               <jats:sec>
                  <jats:title>Results</jats:title>
                  <jats:p>Data from 3293 referral letters and 2468 response letters from 68 general practices and 17 hospitals were analysed. The median time that had elapsed between a patient being referred and receiving a response letter was 4 weeks, ranging from 1 week for Emergency Department referral letters to 7 weeks for orthopaedic surgery referral letters. Referral letters included the reason for referral (98%), history of complaint (90%) and current medications (82%). Less commonly included were management prior to referral (65%) and medication allergies (57%). The majority of response letters included information on investigations (73%), results (70%) and follow-up plan (85%). Less commonly, response letters included medication changes (30%), medication lists (33%) and secondary diagnoses (13%).</jats:p>
               </jats:sec>
               <jats:sec>
                  <jats:title>Conclusions</jats:title>
                  <jats:p>Future research should be aimed at developing robust strategies to addressing communication gaps reported in this study.</jats:p>
               </jats:sec>},
  year = {2019},
  journal = {Fam Pract},
  volume = {17},
  pages = {63-68},
  month = {07/2019},
  publisher = {Oxford University Press (OUP)},
  issn = {1460-2229},
  doi = {10.1093/fampra/cmz037},
}