Referral for specialist advice
Clinicians should endeavour to recognize the early signs of serious disease and to direct the patient to the appropriate specialist for a second opinion, including results of any relevant investigations.
Patients who may benefit from specialist referral include those where there is:
a possibly complex or serious diagnosis (e.g. cancer, pemphigus, HIV/AIDS Behçet disease, Crohn disease)
extraoral involvement or possible systemic disease
investigations required, but not possible, or appropriate to carry out, in primary care
a situation where therapy may not be straightforward and may require complex agents
a situation where drug use needs to be monitored with laboratory or other testing
a patient who needs repeated access to an informed opinion, outside normal working hours.
Essential details of a referral letter include the following:
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