• health policy & practice

In the last 10 years, referrals from general practitioners (GPs) to neurologists in the UK and elsewhere have shifted from letters, which are then placed in paper notes, to electronic referrals, which are incorporated into electronic care records. For even longer, some neurologists have found they can triage a proportion of their GP referrals either to advice or to investigations without needing a clinic attendance. Electronic referral makes this triage process much easier; however, even if not using an electronic care record, the neurologist can send the triage response to the referrer by email, with a print copy incorporated in paper-based records. In England, National Health Service (NHS) Digital—the information technology wing of England’s NHS—facilitates such triage with an advice and guidance module incorporated into its electronic care record; GPs can refer to this instead of to the conventional referral system. (Confusingly, this is called the referral assessment service,1 and even more confusingly, it can also …