An evaluation of referrer factors for 98,671 referrals made to the West Yorkshire oral surgery managed clinical network over a three-year period

Abstract

Introduction Patients referred from primary dental care to hospital-based specialists in high volumes can contribute to significant NHS service pressures. Surprisingly, little is understood about what contributes to referral factors.

Aims To gain new insight into the referral factors from primary dental care by interrogating the tri-speciality West Yorkshire managed clinical network (MCN) referral pathway data for a 36-month period (2016-2019).

Methods Anonymised referrals from the electronic referral management system were collated for analyses.

Results There were 98,671 referrals within the 36-month period, 12.3% of which were rejected. Of those accepted for triage, 76% were directed at oral surgery, with >60% accounted for by exodontia. In total, 10% of referrers accounted for 60% of all referrals. Peak referral occurred five years after General Dental Council registration.

Discussion This is the first report of referral data from a tri-speciality MCN with exodontia referrals predominating. The data set demonstrates variation in referrer behaviours despite referral guidance. Referrals should be based upon patient need but patterns observed in this study suggested possible associations with high and low referral patterns which warrant further research.

Conclusions Interrogation of the referral database suggests that there are interesting patterns of referral which may be associated with characteristics of the referrer as well as their patients' needs. Further investigation could inform improved processes and service design, as well as education delivery and workforce development.

Key points

• Describes referrals for a tri-speciality MCN over 36 months with insight into the service demand for oral surgery, oral medicine and maxillofaical surgery in West Yorkshire and highlights referral behaviours showing that 60% of all referrals are accounted for by 10% of referrers.

• Oral surgery referrals accounted for over 75% of all referrals of which the majority were exodontia. Almost 20% of all referrals were in the 'other' category.

• Highlights the need for further studies both of a quantitative and qualitative nature to better understand referrer behaviours and how these impact on future service design and workforce training.