Annex A > Chapter 11 - Referrals > Referrals to Bristol - information available to referring clinicians about standards at Bristol or elsewhere and factors influencing referral patterns > The role of the referring clinician

The role of the referring clinician

56 The letters from referring clinicians provide evidence on the factors influencing their referral patterns. However, it should be noted that six referring clinicians expressed the view that it was not part of their role to monitor or assess standards at Bristol or elsewhere. Many made the point that a consultant paediatrician would only rarely expect to see congenital heart defects in their practice.

57 Dr R Prosser: [66]

`I do not feel that a General Paediatrician in a District General Hospital is in a position to compare the level of excellence of different Units in the country especially when considering the variety and rarity of some of the conditions and the lack of any specific directive from any other source.'

58 Dr A McNinch: [67]

`I knew of successes and failures but I never formed the opinion that results from Bristol were "poorer than expected" in comparison to those from other units, nor did I feel able to make such a comparison. I do recall the subject being discussed at one of the monthly meetings between the Exeter consultant paediatricians, probably in the early 1990s, one of my colleagues said that he was concerned that some of the results were poorer than he would have expected but I argued that he was in no position to make judgement because the evidence was anecdotal and involved small numbers.'

59 Dr D Stevens: [68]

`We expected, and still expect, regional centres not to differ significantly in the standard of care and results.'

60 Dr N Gilbertson noted that a change in practice had taken place in recent years: [69]

`I would not have seen it as my place as a District General Paediatrician to be overseeing the performance of the regional centre. However, my practice has now changed and I do expect those centres to whom I refer children to provide me with data confirming that their standards of practice are in keeping with national standards.'

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Footnotes

[66] Consultant paediatrician, formerly at Royal Gwent Hospital, Newport, REF 0001 0132 Dr Prosser

[67] Consultant paediatrician, Royal Devon and Exeter Hospital, Exeter, REF 0001 0046

[68] Consultant paediatrician, Gloucestershire Royal Hospital, Gloucester, REF 0001 0007

[69] Consultant paediatrician, Royal Cornwall Hospital, Treliske, Truro, REF 0001 0038