Quality of GPs' referral letters to diabetes secondary care

Good quality referral information enables appropriate triage and the best use of scarce secondary care resources. We evaluated the quality of GPs' referral letters to our district general hospital diabetes centre to identify types of information that receive the highest and the least priority with the objective of developing constructive feedback. Eighty‐one letters from 51 GPs, excluding requests for reassessment, emergency inpatient care or non‐diabetic concerns, were evaluated on 24 parameters of varying clinical importance and categorised as ‘low’(0.0–9.9), ‘mid’(10.0–19.9) or ‘high’ (20.0–30.0) scoring (total 30.0 points). Total scores ranged from 4.5 to 30 (mean 13.3). Mean per cent scores (95% confidence intervals), for selected parameters were: home glucose monitoring 29.6 (19.9 to 39.3); HbA1c 47.8 (38.3 to 57.4); retinal surveillance 32.1 (21.9 to 42.3) and complications 30.9 (20.9 to 40.8); microalbuminuria 28.4 (18.4 to 38.3) and renal complications 23.5 (14.3 to 32.6); foot care 19.8 (11.0 to 28.5) and complications 24.1 (14.9 to 33.2); blood pressure 41.4 (30.9 to 51.8); bodyweight 30.3 (20.9 to 39.6). Low‐scoring letters (32.1%) regularly provided five items of information, mid‐scoring (51.9%) 10 items and high‐scoring (16.1%) 20 items. Overall, letters were lacking in information regarding surveillance, recognition and management of microangiopathy, blood pressure, body weight, home glucose monitoring and biochemistry. High‐scoring letters reflected good insight into the care of people with diabetes. Copyright © 2003 John Wiley & Sons, Ltd.