Understanding the Referral Workflow
Understanding the Referral Workflow
The referral workflow provides a visual overview of how patient referrals progress between Primary Care, Referring Organisations (Optical Practices) and Secondary Care (Hospital Services).
Understanding this process is important for all users involved in managing, reviewing and triaging referrals. It helps ensure that referrals are processed appropriately, the correct clinical information is captured, and patients are directed to the most suitable service.
This guide explains how to interpret the referral workflow diagram, understand the different stages of the referral journey, and identify the forms and actions associated with each stage.
1. What Does the Workflow Show?
The referral workflow illustrates the journey a patient referral may take from its initial creation through to the appropriate clinical assessment, referral management decision, or onward transfer to another healthcare service.
The diagram is divided into three main areas, representing the organisations or services involved in the referral process:
Hospital (Secondary Care)
This section represents the activities undertaken by hospital-based clinical teams when a referral is received for assessment or triage.
Depending on the clinical pathway and information provided, hospital users may be required to review the referral, complete a clinical triage assessment, or determine the appropriate next steps for the patient.
The workflow highlights how decisions made during triage can influence the subsequent direction of the referral.
Referring Organisation (Optical Practice)
This section represents the organisation responsible for initiating or managing the referral via the WGOS Referral Form before it reaches the appropriate receiving service.
It includes the initial referral submission and any additional management or clinical decisions required to determine where the patient should be referred.
The workflow also identifies circumstances where additional information or further assessment may be required before the referral can progress.
Optical Practice Avaiable Actions
This section represents the involvement of optical practices within the referral pathway.
Depending on the outcome of the referral assessment, an optical practice may be required to review or accept a referral, provide additional information, or undertake further clinical assessment.
The diagram demonstrates how referrals may move between optical practices and other healthcare services depending on the patient's clinical requirements.
Not every referral will follow the same route through the workflow. The pathway taken will depend on the information provided, the clinical decisions made, and the services required by the patient.
2. How to Use the Workflow Diagram
The workflow diagram should be used as a visual reference to help understand the different stages of the referral process and the actions that may be required at each point.
When reviewing the diagram, follow the steps below.
Step 1: Identify your role
Begin by identifying which section of the diagram relates to your role or the referral you are reviewing.
The diagram is separated into Hospital, Referring Organisation (Optical Practice) and Optical Practice actions sections.
This allows you to understand which organisation is responsible for a particular action and where the referral may move next.
Step 2: Locate the Current Stage of the Referral
Identify the point within the workflow that corresponds to the current status or activity associated with the referral.
For example, a referral awaiting hospital triage should be reviewed against the hospital section of the workflow.
This will help you understand what actions may be required before the referral can progress.
Step 3: Follow the Directional Arrows
The arrows connecting the different stages indicate the direction in which a referral may progress.
Follow these arrows to identify the possible next stages of the referral journey.
Some stages may lead directly to another form or action, while others may require a decision before the referral can continue.
Step 4: Review Decision Points
Throughout the workflow, diamond-shaped boxes represent decision points.
These identify stages where the referral may follow different routes depending on the outcome of an assessment or decision.
For example, the outcome of a clinical triage assessment may determine whether the patient requires further hospital assessment, onward referral, or another appropriate clinical service.
Where multiple routes are available, follow the arrow corresponding to the relevant decision or outcome.
Step 5: Identify the Required Form or Action
The coloured boxes within the diagram represent forms or specific stages of the referral process.
When a referral reaches one of these stages, refer to the relevant form or process indicated.
The colour-coded key below provides further information on how to interpret these boxes.
Step 6: Identify the Next Destination
Continue following the workflow until you identify the next destination or required action.
This may involve further clinical assessment, referral management, transfer to another provider, or onward communication to a dedicated booking team.
When using the workflow, focus on the current stage of the referral first. You do not need to memorise the entire diagram. Instead, use it to understand the relevant decision points and the possible next steps for the referral.
3. Why Is Understanding the Referral Workflow Important?
Understanding the referral workflow helps users develop a clear picture of how referrals move between different healthcare organisations and the actions required throughout the process.
For Hospital users (Secondary Care), this is particularly important when reviewing referrals and making clinical triage decisions.
Understanding Responsibilities
The workflow identifies the different organisations involved in the referral journey and the stages at which they are responsible for taking action.
This helps users understand which activities are undertaken within Hospital settings (Secondary Care) and which are managed by other services (Primary Care).
Supporting Accurate Referral Management
By understanding the different routes available within the workflow, users can better recognise how decisions affect the onward progression of a referral.
This supports consistent referral management and helps users understand the intended next steps following a clinical decision.
Improving Visibility of the Patient Journey
The workflow provides an overview of the patient's journey across different healthcare settings.
It demonstrates that a referral may involve multiple organisations, assessments and decisions before reaching its final destination.
Understanding this wider process helps users recognise how their actions contribute to the overall patient pathway.
Identifying Forms and Actions
The diagram identifies the forms associated with different stages of the referral process.
This helps users understand when specific information may need to be recorded and which form is relevant to a particular stage of the workflow.
Supporting Training and Troubleshooting
The workflow can also be used as a training and reference resource when users are unfamiliar with a particular referral route.
For example, if a user is unsure why a referral has moved to another service, the diagram can help explain the decision points and possible outcomes associated with that stage.
It can also support discussions between teams when clarifying the expected progression of a referral.
4. Referral Workflow Diagram
Figure 1 below provides an overview of the full referral workflow between the Optical Practice (Primary Care) and Hospital (Secondary Care).
The diagram illustrates the different forms, decision points and potential referral destinations throughout the process.
Use this diagram alongside the guidance provided in this article to familiarise yourself with the overall referral journey.
For easier viewing, you can open the diagram in a separate browser tab using the link below.
View Full Referral Workflow Diagram
5. Understanding the Workflow Key
The workflow uses different coloured boxes and symbols to distinguish between forms, actions and decision points.
Understanding these visual indicators will help you navigate the diagram and identify what is required at each stage.
Forms Used Within the Referral Process
The orange, yellow, purple and blue boxes indicate forms associated with particular stages of the referral journey.
These boxes help identify which form needs to be completed or reviewed at the relevant stage.
| Colour | Meaning |
|---|---|
| Orange | Indicates the initial WGOS Referral form that starts the referral process from an Optical Practice (Primary Care). |
| Yellow | Indicates the WGOS Triage Clinical Form. This form is completed when a referral has been sent to a Hospital setting (Secondary Care) and requires Triage before acceptance and booking by the Trust. |
| Purple | Indicates the WGOS Referral Management Form. This form is completed by an Optical Practice (Primary Care), where a practice may have sent a referral to another Primary Care setting, and it has been rejected back to them. The WGOS Referral Management Form allows the original optical practice to then further manage the referral and its pathway. |
| Blue | Indicates the WGOS Referral Acceptance Form. This form is completed by an optical Practice (Primary Care) where they have been sent a referral from another optical practical practice. |
| Green | Indicates the WGOS Optical Practice Management Form. This form is completed when a Hospital is returning the referral back to the optical practice requesting further information or returning to practice with advice. |
The colour of the box helps identify a form within the workflow. Always refer to the form name displayed inside the box to understand which form is required.
Pink Boxes – Referral Sent to Booking Team
Pink boxes indicate a stage where the referral is emailed to the dedicated booking team or designated endpoint.
These stages represent the onward communication of a referral following the relevant assessment or decision within the workflow.
The receiving booking team will then manage the referral in accordance with their existing booking processes.
For Secondary Care users, it is important to recognise that the pink boxes indicate the onward transfer of referral information rather than an additional form that must be completed.
Booking teams do not access the referral application directly as part of this process. Instead, they receive the relevant referral information through the established email process.
Diamond Shapes – Decision Points
Diamond-shaped boxes represent stages where a decision is required to determine the next step in the referral journey.
Depending on the outcome, the referral may progress along one of several possible routes.
Follow the directional arrows from the diamond to identify the appropriate next stage.
Directional Arrows – Referral Movement
The connecting arrows show how referrals move between forms, decisions and healthcare organisations.
They help illustrate the sequence of actions and the potential routes a referral may take.
Where a pathway branches, the relevant decision determines which arrow should be followed.
6. Using the Workflow in Practice
The workflow is particularly useful when reviewing a referral that requires a clinical decision.
Consider the following example of how the diagram may be used.
Example: A Referral Requiring Hospital Triage
- Referral received:
A referral progresses to the hospital for clinical triage. - Identify the triage stage:
The hospital user locates the relevant triage stage within the Hospital section of the workflow. - Review the referral:
The clinician reviews the clinical information provided and undertakes the required triage assessment. - Determine the outcome:
The clinician identifies the appropriate next step based on the clinical assessment. - Follow the relevant pathway:
The workflow arrows indicate the possible onward routes following the triage decision. - Identify the next action:
Depending on the outcome, the referral may require further assessment, onward transfer, or communication to a designated booking team.
This example demonstrates how the workflow can be used to understand the relationship between clinical decisions and the onward progression of a referral.
The workflow diagram is intended to support understanding of the referral process. It should not replace clinical judgement, local clinical guidance, or the instructions provided within the referral application.
7. Key Points to Remember
- The workflow provides an overview of the referral journey between Primary Care (Optical Practices) and Secondary Care (Hospital Settings).
- Each section of the diagram represents the organisation responsible for the relevant stage of the referral process.
- Orange, yellow, purple and blue boxes identify forms associated with different stages of the referral pathway.
- Pink boxes indicate that the referral is emailed to the dedicated booking team or designated endpoint.
- Diamond shapes represent decision points where the referral may follow different routes.
- Directional arrows show how referrals progress between stages and healthcare organisations.
- Not every referral follows the same pathway. The route depends on the relevant clinical decisions and referral requirements.
- The workflow should be used as a supporting reference alongside the relevant application guidance and local clinical procedures.
8. Further Support
If you are unsure how a particular referral should progress, please use help button via the blue bubble to contact the OPERAi Support Desk.
For additional information about completing clinical triage activities, please refer to the relevant Secondary Care training and support articles.