Referral optimisation

Expert care closer to home

In the past, GPs would routinely refer patients to hospital without having had input from a clinician in the relevant field. Now, GPs have access to expert advice from a range of specialities to discuss the most appropriate care for a patient before they refer for an outpatient appointment.

This might involve GPs sending photographs of the patient’s condition to the specialist or having online and phone conversations with them to establish the next steps.

Having access to this advice results in quicker diagnoses and treatment and also helps reduce the need for a patient having to be referred to hospital, saving people time, money and stress. If a patient does need to be seen by a specialist, the right support and clinician can be identified at an earlier stage, making better use of the time spent at the appointment.

People living with long term conditions are better supported through this improved access to specialist care. It gives patients confidence to manage and monitor their condition at home without the need to attend hospital on a regular basis.

This process of accessing expert care through GPs is sometimes called referral optimisation.


Teledermatology is the use of digital images to triage, diagnose, monitor and assess skin conditions without the patient being physically present.

Teledermatology can be used to support referral optimisation, as well as the virtual urgent suspected skin cancer pathway, and validation and clinical prioritisation of dermatology waiting lists to support elective recovery.

NHS England’s teledermatology roadmap is available to support systems to accelerate their teledermatology rollout, setting out practical steps to help providers implement an efficient, safe and effective teledermatology service. A variety of resources are also available on FutureNHS.


More detailed specialty specific guidance is also available through the Outpatient transformation FutureNHS workspace (this platform requires a log in) along with FAQ’s and a selection of other support tools and resources.