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Factors influencing general practitioner referrals to a tertiary paediatric neurodisability service
1Neurodisability Service, Wolfson Centre, Great Ormond Street Hospital for Children NHS Trust, London.
Insights
Parental concerns significantly influence general practitioner (GP) referrals to paediatric neurodisability services. GPs often refer children for a second opinion, with parents driving the decision-making process.
Area of Science:
- Pediatric Neurology
- Health Services Research
Background:
- General Practitioner (GP) referrals are crucial for accessing tertiary paediatric neurodisability services.
- Understanding referral drivers is essential for optimizing child disability health services.
Purpose of the Study:
- To investigate factors influencing GP referrals to a tertiary paediatric neurodisability service.
- To examine the role of parental concerns and secondary specialist involvement in these referrals.
Main Methods:
- A cross-sectional study involving 50 general practitioners (GPs) who referred patients to a tertiary paediatric neurodisability service.
- Data collected via postal questionnaires and interviews.
Main Results:
- Two-thirds of GPs did not consult secondary specialists before referral.
- 78% of referrals were driven by parental concerns, often due to a lack of diagnosis (74%).
- 90% of referrals were for parents seeking a second opinion outside their local network.
Conclusions:
- Parental influence is a significant factor in GP referrals to tertiary neurodisability services.
- Effective organization of child disability services needs to consider the impact of parental requests and second opinions.
Abstract:
This study investigated factors influencing general practitioner (GP) referrals to a tertiary paediatric neurodisability service, including the reasons for referral, the children's characteristics, and the involvement of secondary specialist services in the referral. Fifty general practitioners (GPs) referring consecutively to the Neurodisability Service, Great Ormond Street Hospital for Children, London, were interviewed in a cross-sectional study using a postal questionnaire. The main findings were that two-thirds of the GPs did not contact secondary specialist providers prior to referring. The majority (78%) of GPs were responding to parental concerns in the context of a lack of medical diagnosis in 74% of the children. The main (90%) reason given for referral was for parents seeking a second opinion outside their district network. The findings highlighted the influence of parents over GPs' referrals to tertiary neurodisability, and, in light of this, raised issues for consideration for effective organisation of child disability health services.