Getting Referrals Right: Learning from Feedback in Primary Care

Patient feedback can be a great way to expose areas for improvement, particularly when it comes to privacy and human rights. Recently, a patient raised a very important concern about the information included in his hospital referral. He noted that, when being referred to the hospital the “Active Problems” section contained irrelevant historic details, including a past mental health episode.

Understandably, he felt this was not appropriate to share, particularly in the context of a straightforward referral for routine blood tests.

This complaint highlighted a wider issue: while electronic patient records are a valuable tool, they sometimes carry more information than is necessary, or even appropriate, for a specific referral. It’s a healthcare provider's duty to make sure that what they share with hospital colleagues is relevant, accurate, and respectful of patients’ dignity.

Data Minimisation in Practice

This issue caused us to reflect on the data protection principle of data minimisation: personal data included in a referral should be adequate, relevant, and limited to what is necessary.

In other words, we aim to provide enough information to support safe, effective care, without including unnecessary details. Importantly, this does not mean inactive or historic problems are always excluded. Sometimes, an older or resolved condition can still be clinically relevant to a referral, and in those cases it should rightly be included. The emphasis is on careful judgement, ensuring the referral is both sufficient and proportionate.

Reflections

Our review showed that including unrelated historic problems can:

• Cause distress for patients, who may feel their privacy is not respected.

• Distract hospital teams from the key clinical issue at hand.

• Lead to inefficiencies, as irrelevant information can cloud the picture.

To address this, consider strengthening the referral process. Do your staff review the “Active Problems” list as part of every referral, removing any items that are not relevant to the patient’s current care. Do line managers oversee this process to ensure accuracy and consistency?

The aim is simple: referrals that are clear, focused, and respectful.

Why This Matters

This process strengthens the commitment to patient-centred care. It ensures that referrals:

• Contain only the information needed to support the patient’s care journey.

• Protect sensitive historic details unless they are directly relevant.

• Give external providers the clarity they need to respond effectively

Mistakes and oversights can happen, but what defines us is how we respond. By listening to this patient’s concern, we’ve been able to improve our systems and evidence our commitment to patient rights.

Emma Kitcher, Healthcare Privacy Nerd