3.1.3 Over-referral and over-burdening services
In relation to the CFIR construct of patient needs and
resources,10 there were concerns from some
participants that additional referrals could over-burden services:
“It could be useful if the right patients are referred but it
could also lead to over-referral as some people may have a certain risk
but will not have cancer after they have been referred and tested ”
(Service User 17: individual interview).
“But on the other side it will put a strain on the NHS; you know
what I mean, on the services there. You know, you don’t want to over
burden the services as well” (Practitioner 4 [GP]: individual
interview).
In contrast, other practitioners felt that while there was a potential
for over-referral, their use of clinical judgement alongside the tool to
refer patients for investigations and specialists’ attention could
reduce the potential for over-referral:
“But as we have said, we are not just referring but we are using
our clinical judgements as well, so we would only refer those patients
that need to be referred – so I don’t think there will be
over-referrals” (Practitioner 1 [GP]: FG 3).