An LMC has created a template letter for GPs to send patients to A&E when they are ‘unable to get through’ to a specialist.
Lincolnshire LMC guidance said that it is ‘best practice’ to discuss referrals for hospital admission with an ‘appropriate specialist’, but that this has recently ‘become more difficult’ as there are now ‘multiple pathways’ to admit patients.
GPs trying to contact a specialist can spend ‘hours’ waiting for the switchboard to answer and then ‘further hours’ for a specialist to answer their pager, to then be told to ‘send the patient to A&E’, it added.
It said: ‘What is even more frustrating is that GPs then get criticised for misusing A&E.’
The guidance added that the LMC has developed a form to ‘counteract’ this that ‘highlights why the patient is in A&E rather than an admissions unit’.
The template letter should be used to ‘indicate why you are sending the patient to A&E rather than admitting through another pathway’ so that ‘the patient gets seen by the appropriate specialist as quickly as possible’, it said.
It lists three options for why GPs are sending patients to A&E:
- The patient has ‘had an accident or is an emergency’, making this the ‘appropriate pathway’;
- The GP has ‘tried to speak to specialist/admissions unit to refer but was unable to get through’;
- The GP has spoken to the specialist or admissions unit but was told to send the patient to A&E.
It also includes space for information on patients’ history of the current issue including symptom duration, medical history, medications and allergies.
The form can also be used to send patients to an urgent treatment centre (UTC), it said.
The LMC added: ‘Please continue to try to make the appropriate specialist referral but if you are unable to get hold of a specialist or they advise you to send the patient to A&E, then please use this form so that the patient gets seen by the appropriate specialist as quickly as possible.’