Mean national Likert-scale values for each of the 20 questions
| Bulgaria | Croatia | Denmark | England | Finland | France | Germany | Greece | Israel | Italy | Netherlands | Norway | Poland | Portugal | Romania | Scotland | Slovenia | Spain | Sweden | Switzerland | |
| Common presentations are covered by local or national guidelines that usually give advice on which patients to refer. | 2.76 | 3.22 | 3.96 | 3.92 | 4.00 | 3.04 | 3.35 | 3.59 | 3.64 | 3.40 | 3.96 | 3.26 | 3.44 | 3.12 | 3.37 | 3.89 | 3.73 | 3.90 | 3.59 | 3.37 |
| The local health system encourages us to refer any patients with possible cancer early, even if there is a low risk of cancer. | 2.78 | 3.00 | 3.91 | 3.29 | 2.97 | 3.29 | 3.79 | 3.37 | 3.60 | 3.05 | 2.84 | 3.20 | 3.18 | 2.97 | 3.68 | 3.31 | 3.28 | 3.07 | 2.91 | 4.05 |
| In my practice, patients often have to travel a long way to see a specialist. | 1.91 | 2.45 | 2.02 | 2.44 | 1.62 | 1.98 | 1.76 | 3.24 | 2.40 | 2.83 | 1.79 | 1.89 | 2.54 | 1.90 | 2.78 | 2.74 | 2.34 | 1.99 | 2.59 | 1.68 |
| I am able to refer directly to a named specialist. | 3.80 | 2.73 | 4.28 | 2.10 | 1.95 | 4.55 | 4.60 | 3.90 | 4.49 | 3.24 | 3.92 | 3.84 | 2.73 | 2.81 | 3.83 | 2.35 | 2.73 | 3.79 | 2.31 | 4.90 |
| I am able to refer to a specialist that I know personally. | 4.14 | 2.89 | 3.38 | 2.02 | 2.00 | 4.24 | 4.39 | 3.86 | 4.26 | 3.41 | 3.74 | 2.67 | 2.77 | 2.27 | 3.81 | 2.34 | 2.92 | 2.52 | 2.29 | 4.87 |
| I can easily telephone (or email) a specialist for informal discussion and advice. | 3.36 | 2.52 | 3.68 | 3.16 | 3.90 | 3.80 | 4.21 | 3.07 | 3.82 | 3.13 | 4.18 | 3.25 | 1.69 | 2.71 | 3.25 | 3.23 | 2.51 | 3.39 | 4.04 | 4.73 |
| Here, specialists usually welcome referrals. | 4.37 | 2.85 | 3.36 | 3.35 | 3.48 | 4.18 | 3.89 | 3.31 | 3.88 | 3.21 | 4.02 | 3.79 | 2.29 | 3.14 | 3.01 | 3.06 | 2.21 | 2.68 | 3.37 | 4.70 |
| Seeing a specialist can be a problem for some of my patients because of the financial cost to them. | 3.22 | 2.82 | 1.74 | 2.28 | 2.64 | 4.06 | 1.74 | 4.36 | 2.21 | 3.70 | 3.90 | 2.15 | 3.13 | 2.71 | 3.80 | 2.02 | 2.70 | 2.12 | 2.04 | 2.32 |
| We have a budget or quota (maximum limit) for diagnostic tests. | 4.36 | 3.02 | 1.68 | 1.87 | 1.92 | 1.60 | 3.18 | 3.63 | 2.21 | 2.44 | 2.03 | 1.34 | 3.52 | 3.22 | 3.09 | 1.51 | 2.88 | 2.72 | 2.07 | 1.35 |
| Here, high-quality care for an individual patient is always more important than costs. | 3.20 | 3.53 | 3.95 | 3.85 | 3.77 | 3.75 | 3.23 | 3.51 | 3.91 | 3.48 | 3.76 | 3.59 | 3.38 | 3.95 | 3.87 | 3.89 | 3.74 | 3.67 | 4.03 | 4.08 |
| Referring or not referring does not affect me at all financially. | 2.69 | 3.13 | 4.41 | 4.07 | 4.20 | 4.67 | 4.18 | 3.68 | 4.33 | 3.31 | 4.28 | 4.46 | 3.52 | 4.29 | 3.99 | 4.43 | 4.04 | 3.63 | 4.26 | 4.27 |
| Referral costs are usually paid by insurance companies, not hospital or primary care budgets. | 2.76 | 3.41 | 1.00 | 1.63 | 1.33 | 2.88 | 3.56 | 2.10 | 2.84 | 1.94 | 4.00 | 1.78 | 2.71 | 1.63 | 3.70 | 1.66 | 4.13 | 1.84 | 1.41 | 4.48 |
| 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. | 2.08 | 2.76 | 1.90 | 2.39 | 2.51 | 2.19 | 1.48 | 2.92 | 2.11 | 2.63 | 2.29 | 2.58 | 3.38 | 2.53 | 2.72 | 2.40 | 3.24 | 2.41 | 2.65 | 1.27 |
| In general, patients prefer a general practitioner (GP), rather than a specialist, to look after them. | 3.12 | 3.09 | 3.40 | 3.00 | 2.61 | 3.00 | 3.67 | 3.56 | 3.52 | 3.30 | 3.53 | 2.99 | 2.98 | 3.12 | 3.53 | 3.23 | 3.49 | 3.22 | 3.12 | 3.65 |
| We have access to a fast-track specialist appointment system for patients with suspected cancer. | 2.71 | 3.22 | 4.75 | 4.66 | 4.08 | 3.46 | 2.87 | 2.45 | 3.33 | 3.22 | 4.30 | 4.67 | 3.63 | 3.42 | 2.58 | 4.37 | 3.22 | 4.06 | 3.31 | 2.27 |
| Patients can self-refer to specialists, so GPs do not need to act as gatekeepers. | 2.39 | 2.04 | 1.41 | 1.39 | 1.92 | 2.29 | 3.19 | 2.58 | 3.10 | 2.65 | 1.61 | 1.59 | 1.83 | 1.86 | 2.38 | 1.38 | 1.55 | 1.45 | 2.75 | 3.02 |
| I am usually very busy, so I sometimes refer to help reduce my workload. | 2.73 | 2.16 | 2.61 | 2.53 | 2.59 | 2.48 | 1.98 | 2.24 | 2.98 | 2.56 | 2.51 | 2.40 | 2.82 | 2.12 | 1.96 | 1.92 | 3.01 | 2.43 | 2.15 | 1.97 |
| I usually have enough time in the consultation to think carefully about whether the patient needs a referral. | 3.32 | 3.52 | 3.43 | 3.02 | 3.15 | 3.77 | 3.86 | 3.49 | 3.16 | 3.67 | 3.59 | 3.75 | 2.64 | 2.58 | 3.90 | 3.29 | 2.91 | 2.83 | 3.16 | 3.69 |
| I am likely to refer if the patient says that she/he would like to be referred, even if there are no ‘red flags’. | 3.10 | 2.59 | 3.02 | 3.20 | 2.51 | 2.96 | 3.62 | 3.42 | 3.69 | 3.36 | 2.92 | 3.11 | 3.63 | 3.05 | 2.80 | 3.00 | 3.30 | 2.88 | 3.06 | 3.52 |
| We are under media (newspaper, television) or public pressure to refer earlier. | 3.84 | 3.04 | 3.38 | 3.97 | 2.82 | 2.81 | 4.16 | 2.69 | 3.16 | 3.42 | 3.10 | 3.80 | 3.61 | 2.42 | 2.65 | 3.92 | 3.36 | 3.23 | 2.50 | 2.77 |
A response of ‘strongly disagree’ was given a score of 1; ‘disagree’=2; ‘neither agree nor disagree’=3; ‘agree’=4; ‘strongly agree’=5.