Health and care experience survey 2017 to 2018: national results

7. Referrals

 

Summary

• Just over two fifths of people were referred to another NHS health professional in the last 12 months, with the vast majority of those being referred by their GP practice.
• People were referred to a very wide range of health professionals. Of the health professionals described, physiotherapist was the most common.
• Seventy eight per cent of people rated the coordination of their treatment / care positively.
• Four in five people were positive about the care they experienced from the service they were last referred to.

 

Introduction

The Memorandum of Understanding between Health and Social Care Partnerships, the British Medical Association, NHS Boards and the Scottish Government also describes the importance of good communication and understanding across the wider health and social care interfaces with both services and professional groups (e.g. primary/secondary, community health and social care services, district nursing, out of hours services, mental health services). This should ensure that people do not fall through gaps in the health and care system.

Due to the increased emphasis on integration of care, additional questions around referrals to other NHS healthcare professionals were included in the 2017/18 survey. The questions were also moved to a standalone 'Referrals' section – previously they were included in the GP practice section – to ensure experiences of those who may have self-referred (without visiting their GP practice within the last 12 months) would be included.

 

Number and Type of Referrals

Just over two fifths of people (42 per cent) had been referred to another NHS health professional in the last 12 months. Of those who had been referred, 90 per cent were referred by their GP practice and ten per cent had self-referred.

In previous surveys, respondents were only asked whether their GP practice had referred them to see any other health or care service in the last 12 months. Just over half of people had been referred (52 and 51 per cent in 2015/16 and 2013/14 respectively) which is notably higher than the proportion referred in the 2017/18 survey. An instruction was added to the latest survey asking respondents to exclude any private referrals and this may account for the difference in response.

Respondents who had been referred in the last 12 months were then asked what type of health professional they were referred to the last time they were referred. Of the health professionals given, physiotherapist was the most common with 16 per cent of people referred to this service. However, just over two thirds of people (68 per cent) were referred to a service not listed and selected the 'Other' response, as shown in Figure 7.1.

Figure 7.1: Type of health professional referred to

Those who selected the response option 'Other' were asked to provide the type of health professional they were last referred to in a free-text box. Initial analysis of these free-text responses looking at common words shows that the most common other types of health professional that people were referred to were Ear, Nose and Throat specialists and consultants. More detailed analysis of these responses will be carried out separately from this report.

It can be seen from Figure 7.2 that, although referral from the GP practice was most common across all the health professions, there were more self-referrals for physiotherapists and podiatrists.

Figure 7.2: Split of referral by GP practice and self-referral by type of health professional

 

Coordination of Treatment and Care

The survey asked respondents to rate the coordination of their treatment / care. Seventy eight per cent of people rated the coordination positively ('Excellent' or 'Good'), with 13 per cent rating it as 'Fair'.

The wording of this question has been changed from that used in previous years to place more emphasis on the overall coordination of the treatment / care ^[22] . However the results are broadly consistent, with 76 and 77 per cent of people rating the arrangements positively in 2015/16 and 2013/14 respectively, compared to the 78 per cent rating given for coordination in 2017/18.

Those who self-referred were less positive about the coordination of their treatment / care, with 70 per cent rating it positively, compared to 79 per cent for those who were referred by their GP practice.

Looking at the responses by the types of health professional referred to, the proportion rating the coordination positively was lowest for those being referred to a mental health professional (69 per cent) and highest for those being referred to a Speech & Language Therapist (92 per cent).

 

Overall Experience of Care

Respondents were asked to rate the overall care they experienced from the service they were last referred to. Just over four fifths of people (82 per cent) rated the care they experienced positively (either 'Excellent' or 'Good') and one in ten people (11 per cent) rated the care they experienced as 'Fair'.

Looking at the responses to this question by type of referral and type of health professional referred to showed similar patterns to those seen for coordination of treatment and care:

• those who self-referred were less positive with 77 per cent rating their overall experience positively, compared to 82 per cent for those who were referred by their GP practice;
• those referred to a mental health professional were had the lowest per cent positive rating for overall care (70 per cent) and those referred to a Speech & Language Therapist had the highest (92 per cent).