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To the letter: hospital clinicians share their referral tips

Optometrist, Rachel Thomas, and ophthalmologist, Melanie Hingorani, outlined the qualities of a good referral letter at 100% Optical

17 Jan 2019 by Selina Powell

The components of a good referral letter were described to delegates at 100% Optical (12–14 January, ExCeL London).

Optometrist, Rachel Thomas, and ophthalmologist, Melanie Hingorani, drew from their experience working in a hospital environment to the highlight the qualities they would like to see in a referral coming from primary care.

They encouraged practitioners to write a legible referral letter that contains the correct patient and referral information, relevant clinical symptoms and the duration of those symptoms as well as ocular history.

The pair also emphasised the importance of practitioners ensuring that the expectations of the patient are realistic.

Ms Thomas told delegates that she started off as an optometrist at Moorfields Eye Centre at Bedford Hospital more than 10 years ago as one of the first optometrists to work at the hospital.

“We started off with a blank sheet which was excellent; it meant that we could design roles within the department,” she shared.

Ms Thomas said that the legibility of referral letters is important because clinicians are often reading up to 100 referral letters at a time.

They need to decide from the information provided which specialty a patient should be referred to and the appropriate timeframe the referral should be made in.

Ms Thomas added that, for patients with multiple issues, one referral letter should be written for each specialty.

Optometrists should not worry overly about terminology when describing signs and symptoms, she said.

“If you don’t know the right term just a description of what you’re seeing and where is usually really useful,” Ms Thomas shared.

Preparing good referral letters is important for optometry to move forwards as a profession, she emphasised.

“We often don’t know our ophthalmologists well face-to-face so our letters are how we are represented,” Ms Thomas said.

The aim should be for optometrists to be making direct referrals to hospital rather than having a GP read the referral first, she emphasised.

Ophthalmologist, Melanie Hingorani, shared that she is “very keen” for ophthalmologists and optometrists to work together more effectively to ease the burden on secondary care.

“In the last few years, the hospital eye service has fallen on its knees with work,” she added.

Ms Hingorani encouraged optometrists to consider the person reading their referral letter.

“Try and put yourself in our place when writing the referral. We will know nothing except what you tell us,” she said.

Image credit: Alpha Stock Images

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    Anonymous

    All good but what are so many optometry referrals hand written ? 1st rule; typed, 2nd rule; full data set, 3rd rule; symptoms presented, 4th rule; signs seen, 5th rule; provisional diagnosis. No need for urgency unless emergency. Finally only refer if the outcome will change for the patient not just 'cos you've seen something. there is no obligation too refer and hasn't been since 2000. If in doubt review and ask a friend.

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