Table 5

Quotes illustrating theme 2

QuoteBarriers between primary care and secondary care which impact on case-finding outcomes
6I mean sometimes you don’t even get anything [from the hospital], sometimes you get nothing but I mean you usually get something, but sometimes you don’t get a discharge summary (GP 01)
7…it might be helpful to know how far, you know, how badly they fail or they pass the test, which type of test they’re doing (GP 15)
8We get sent the information, it’s unsolicited, it’s using a tool which we do not use ourselves therefore we don’t have an awful lot of experience in…but it’s a shame that there isn’t a tool used across both sectors that we could compare results with (GP 14)
9I know a lot of my colleagues often it will be ignored so it’s not really followed up, not intentionally or whatever, but it just gets lost in the volume of information that we’re given (GP 07)
10…you see the patient is getting mucked about because they’re having to have more tests done and it’s really very poor cost effectiveness for the NHS because, you know, tests are being duplicated (GP 01)
11In our area we are even trying to see if the GPs can request a CT scan as well, so that, you know, by the time the patient has seen the old-age psychiatrist, everything is there, all the old-age psychiatrist has to do is see the patient and diagnose (GP 06)
12…when I was trained in elderly psychiatrics about ten years ago on an elderly ward it was a dementia diagnosis was done there and then, and then everything was put in place. It’s only after the Memory Clinics came on board that it got a bit fragmented. Dementia diagnosis was done at the hospital as well as community at the time and, you know, both by psychogeriatricians but also by the geriatricians (GP 05)
13…actually you’ve picked up a problem, get on and do the referral rather than sending them back (GP, Focus group 2)
14[The letter] will say the psychiatrist thinks they need further treatment…why can’t the ward make the referral, ‘cos then that would shorten the interval for waiting (GP, Focus group 1)
15I’ve had a few doctors recently say to me, they don’t quite understand why we have to go through the GP, why don’t we just refer straight to the Mental Health Trust directly? And that’s a fair point, because it is cutting out yet another layer where it can go wrong, maybe, or delays (Hospital staff 07)
16“Look, we’ve identified this, we’re now passing the buck to you and we haven’t done anything about it” and that’s unfortunately what seems to happen a lot (GP 12)
17…we used to get quite a few calls [from GPs] to say, “What is my responsibility? What are you asking us to do?” (Hospital staff 14)
  • GP, general practitioner.