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12.3 Referrals

Independent practitioners may only accept requests for examinations involving ionising radiation from Registered Health Care Practitioners (ie they must be registered under a statutory regulatory body in the UK). Requests must be properly authorised in accordance with established criteria, national guidelines and evidence based practice and the examination requested must be of benefit to the patient.24 The request must contain sufficient clinical information to justify the examination and the Ionising Radiation Regulations and its amendments followed. Independent practitioners may carry out alternative or additional examinations where, in their professional judgement, these are appropriate to the patient’s condition.

Independent practitioners may, however, accept self-referrals for relevant examinations that do not involve ionising radiation; ultrasound examinations would be an example. It must be noted that there is no mechanism for self-referral under the Ionising Radiation regulations and subsequent amendments. SCoR advice on self-referrals was published in 2010 and is available from the document library.24

For ultrasound examinations, a verbal self-referral from the patient themselves is acceptable but the reasons for the request should be recorded on the report and the sonographer must be able to justify the examination.

Independent practitioners must use their own professional judgement and not carry out any imaging (whether referred or self-referred) where, in their professional opinion, the risk to the patient is greater than the benefit obtained by the procedure. It is good practice to go back to the referrer in cases where this is in doubt.

The independent practitioner should ensure that the patient or client has been assessed appropriately prior to undertaking the examination and has given their consent.

  • The examination should take place in a clinically appropriate environment.
  • Patients must be fully informed of the implications of their examinations and the importance of disclosure of results to their general practitioner/referrer.
  • A copy of the results, any risk assessment and information given to the patient is sent to the referrer for their records, so ensuring continuity of care. This is an important standard for the protection of the public.
  • The independent practitioner maintains full records for future reference.

The National Screening Committee has issued Public Guidance on Screening which links with this section on referrals (October 2010). Independent practitioners should be aware of this advice and how it may affect their practice. “Thinking of having a private screening test?” can be downloaded from

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