what documentaion do other community matrons fill in, when they see a patient that is not an approriate referral. I am thinking about a patient that may have been referred by a GP, on visiting the patient it was noted that they just needed referring to a district nurse for example. it seems a waste of time to complete a full set of notes, so i was wondering what others where using to document such visits.

thank you, i am new in post.

I have just come into post last week so am very new as well, we have not as yet got to the identification of appropiate patients for the caseload. However i would imagine that ensuring they fit an approipiate referral criteria would be a good way to aviod going out to undertake an assessment and filling in forms, only to find the patient was not suitable. I would think that feeding this back to the GP would be useful to avoid it happening again, and also passing any assessment undertaken to the relevant DN would be useful to them, it also may help build relationships with the DNs. As to your question of a form for an inappropiate referral I would think that this needs recording and the reasons why as this may well help identify any patterns. this probably does not answer your question but hope it was still helpful Amanda

We have the referral criteria built into our referral form so it's difficult to get past first base when the form is being used inappropriately. In cases where the GP is not familiar with the service it can create a good opportunistic reason to chat with them and open up some communication pathways, I always find that relating service potential to a specific patient seems to illustrate more clearly what we are trying to do (or not if it's inappropriate!).
We also use a communication form with GPs for all information, as it's freehand you can state your reasons why the referral has not been accepted, generally I try and keep the form for positive stuff unless its a practice that is well established with the service. Hope that helps. Lesley

Is the referral inappropriate because of the referal source or the referral criteria

Hi,
I don't fill in the full paperwork when patients are not taken on. I tend to write the assessment on theback of the patients referral form. What I also do is write the the referree explaining my reasons for not taking on the patient, and keep a copy with the notes. I think it's not unreasonable to see patients that you are not going to take on, as often the referrer hasn't given sufficient information, or got the gist of our role, so inevetabley you see patients that you won't keep on. I have been in post for 18 months, so have had some experience of not taking patients on.

Identifying patients using the combined predictive risk tool is more successful then threshold referral criteria and has greatest impact on the system. This is the model used on our virtual wards in croydon.

There is no such thing as an inappropriate referral. The referral may be 'avoidable' and it is the responsibility of the practitioner to ensure that the patient resumes the appropriate pathway.