Unfortunately different hospitals and different PCTs (probably not called PCT anymore) have different protocols and if you work in different locations (or on the borders of different hospital catchment areas) managing referral etiquette is a night mare
Our local GP’s don’t/won’t have any referrals directed via them – we MUST use a central referral service for routine referrals (unless patient’s GP is in a different area).
We have one localish hospital who can be contacted by fax for urgent referrals (but many Patients don’t want to travel that far), but it is easier for us because nearest hospital clinic never or takes forever to answer the phone and I won’t trust them with fax message.
We have a local Optom who can triage some emergency retinal conditions in preference to direct referral.
Wet AMD referral is relatively straight forward.
Just would like standard protocols as all Ophthalmologists seem to have different criteria as to who they want to see as emergency or urgent – and we are expected to know who needs to be seen urgently or same day (sometimes it is obvious but as we don’t have latest high tech equipment not always).
In many ways GOS 18 via GP was so much simpler (oh for the good old days!)