ABSTRACT
This chapter begins with a visit by the patient either to their GP, or to an Accident and Emergency department, or to one of the few direct-access services offered by some hospitals. A referral letter or specially designed referral form is sent by the GP to the appropriate consultant with an outline of the patient's condition. An on-line appointment booking system has been piloted which enables GPs to book patients directly into specific consultant clinics. Admissions from the waiting-list are usually handled by an admissions office, which is also responsible for keeping an accurate bed state for the entire hospital. The term 'clinical audit' embraces the audit activity of all healthcare professionals, including nurses, doctors and other healthcare staff. The Healthcare Commission has been responsible for reviewing every trust's performance and awarding an annual performance rating, usually referred to as a 'star rating'.
