Agree with everything AHS71 says.
Can I ask those who hold their referrals till later in the day how they fulfil their legal obligation of giving patient a copy of reasons for referral. I find that is easiest done by giving them a copy before they leave the room. You cannot do that by completing referral after they have left. If contractor insists, quote regs to them. They cannot insist you ignore them. (If you don’t know regs, you have a problem anyway).
I would also suggest those with high referral numbers to ask themselves why. I think that anyone who has lots of referrals may be over referring and nowadays could be asked by NHS England why there referral rates are higher than other local colleagues. The NHS used to collect outcome data on contractor claims only, but they were planning last year to begin recording outcomes of sight tests per performer, to find out individuals who are prescribing low or no change Rxs. Over referring,cloggs up outpatients for spurious reasons and cost 1 tariff appointment cost ( my local tariff is £108 for initial consultation with a clinician plus a follow up fee of £58 for every other clinical incident eg fields by orthoptist asked for by ophthalmologost). We taxpayers have to pick up that possibly unnecessary bill as unnecessary referrals costs soon add up. In my other role as an Clinical Advisor, I had to arrange mentoring and support courses for a few poorly performing practitioners, so help is available, if necessary. The College will also help members whose performance is not quite satisfactory.