Table 4

Mean national Likert-scale values for each of the 20 questions 

Common presentations are covered by local or national guidelines that usually give advice on which patients to refer.2.763.223.963.924.003.043.353.593.643.403.963.263.443.123.373.893.733.903.593.37
The local health system encourages us to refer any patients with possible cancer early, even if there is a low risk of cancer.2.783.003.913.292.973.293.793.373.603.052.843.203.182.973.683.313.283.072.914.05
In my practice, patients often have to travel a long way to see a specialist.1.912.452.022.441.621.981.763.242.402.831.791.892.541.902.782.742.341.992.591.68
I am able to refer directly to a named specialist.3.802.734.282.101.954.554.603.904.493.243.923.842.732.813.832.352.733.792.314.90
I am able to refer to a specialist that I know personally.4.142.893.382.
I can easily telephone (or email) a specialist for informal discussion and advice.3.362.523.683.163.903.804.213.073.823.
Here, specialists usually welcome referrals.4.372.853.363.353.484.183.893.313.883.214.023.792.
Seeing a specialist can be a problem for some of my patients because of the financial cost to them.3.222.821.742.282.644.061.744.362.213.703.902.153.132.713.802.022.702.122.042.32
We have a budget or quota (maximum limit) for diagnostic tests.4.363.021.681.871.921.603.183.632.212.442.031.343.523.223.091.512.882.722.071.35
Here, high-quality care for an individual patient is always more important than costs.3.203.533.953.853.773.753.233.513.913.483.763.593.383.953.873.893.743.674.034.08
Referring or not referring does not affect me at all financially.2.693.134.414.074.204.674.183.684.333.314.284.463.524.293.994.434.043.634.264.27
Referral costs are usually paid by insurance companies, not hospital or primary care budgets.2.763.411.001.631.332.883.562.102.841.944.001.782.711.633.701.664.131.841.414.48
My colleagues sometimes criticise me if I have referred a patient to them, but they think that I should have been able to manage the patient myself.2.082.761.902.392.512.191.482.922.112.632.292.583.382.532.722.403.242.412.651.27
In general, patients prefer a general practitioner (GP), rather than a specialist, to look after them.
We have access to a fast-track specialist appointment system for patients with suspected cancer.2.713.224.754.664.083.462.872.453.333.224.304.673.633.422.584.373.224.063.312.27
Patients can self-refer to specialists, so GPs do not need to act as gatekeepers.2.392.041.411.391.922.293.192.583.102.651.611.591.831.862.381.381.551.452.753.02
I am usually very busy, so I sometimes refer to help reduce my workload.2.732.162.612.532.592.481.982.242.982.562.512.402.822.121.961.923.012.432.151.97
I usually have enough time in the consultation to think carefully about whether the patient needs a referral.3.323.523.433.023.153.773.863.493.163.673.593.752.642.583.903.292.912.833.163.69
I am likely to refer if the patient says that she/he would like to be referred, even if there are no ‘red flags’.3.102.593.023.202.512.963.623.423.693.362.923.113.633.052.803.003.302.883.063.52
We are under media (newspaper, television) or public pressure to refer earlier.3.843.043.383.972.822.814.162.693.163.423.103.803.612.422.653.923.363.232.502.77
  • A response of ‘strongly disagree’ was given a score of 1; ‘disagree’=2; ‘neither agree nor disagree’=3; ‘agree’=4; ‘strongly agree’=5.