Referring a patient: how the practice works with doctors
Written by Julie Martin, State-registered nurse · · 3 min read
Reviewed on · Reviewed by Rabah Slimani
Response times, handover format, alert criteria, holiday continuity, traceability: what a doctor gets when referring a patient to us, written down.
Key points
- A feasibility answer the same day, including the first visit date.
- A written report after the first visit, then at every notable event — no three-week silence.
- Alert criteria agreed with you in writing, so the call arrives at the right moment.
- Holiday continuity on the same protocols, with no restart from scratch.
What you should expect from a practice
A doctor who refers a patient takes a risk: daily observation is delegated to someone they will never watch work. The only thing offsetting that risk is the quality of the information coming back.
So we treat reporting as part of care, not as administrative courtesy. A practice that never writes to you is not saving your time: it is removing your eyes from the home.
Our response commitments
These are commitments, not intentions. They are measurable and you may hold us to them.
| Situation | Our deadline | Channel |
|---|---|---|
| Referral request | Same day | Phone or form |
| First-visit report | Within 48 hours | Secure messaging |
| Unexpected clinical sign | Immediate | Phone, then in writing |
| Refusal or inability to take the patient | Same day, with redirection | Phone |
| Periodic review of a long follow-up | Monthly | Secure messaging |
What a report contains
Our handovers follow a constant format so you find the information in the same place every time.
- Date, time and duration of the visit, name of the nurse who attended
- Procedure performed and compliance with the prescribed protocol
- Objective findings: vital signs, wound appearance, pain score, adherence
- Any deviation from what was expected, and the action taken
- A precise question for the prescriber, when there is one
Alert criteria, defined with you
Alerting too early floods your day; alerting too late presents you with a fait accompli. The only way out is to set thresholds in advance, patient by patient.
When follow-up starts we propose three to five written criteria: temperature, local appearance, a laboratory value, weight, pain, food refusal. You confirm or correct them, and they become the rule.
Outside those criteria we do not call: we write. Faced with a possible acute situation we call — and we accept that the call may turn out to be unnecessary.
How to refer a patient
Four pieces of information are enough for us to answer immediately.
The procedure and its frequency
As they will appear on the prescription, with the expected duration.
The patient's address
It determines feasibility: our area is defined and published on this site.
The preferred first visit date
We confirm the actual slot, or propose the closest alternative.
Known particulars
Isolation, pets, cognitive impairment, equipment already delivered, supplier involved.
Continuity, locums and traceability
Every patient has a written, dated protocol: products, technique, frequency, alert criteria, prescriber contact. A locum works from that document, not from a verbal instruction.
Handover notes are kept and can be shared with you on request, including retrospectively, which makes follow-up verifiable rather than declarative.
Health data is exchanged through secure messaging. We do not send wound photographs by text message, even on request.
What we do not do
We never modify a prescription, never suggest a treatment in the doctor's place, and never perform procedures outside our regulated scope.
We do not solicit colleagues' patients and publish no comparison with other practices: the nurses' code of ethics forbids it, and rightly so.
Respecting each party's scope is not caution: it is the condition for your prescription to be carried out exactly as written.
What makes a referral immediately usable
A complete referral is accepted or declined in one reading. An incomplete one costs two phone calls and a day's delay.
- Prescribed procedure, frequency, duration, desired start date.
- Exact address and floor, with entry code if needed.
- A reachable contact for the patient or the main relative.
- Clinical details useful to the procedure, without excess: what changes how care is delivered.
- Supplies already prescribed, chosen provider, delivery date.
- What you expect back from us, and by when.
Our limits, stated plainly
We decline a referral when the address is outside the covered area, when the procedure is outside our scope, when essential supplies are unavailable, or when the round is already full at the time the care requires.
In those cases we answer quickly and redirect rather than leaving a request unanswered: that is the only stance that protects the patient and your organisation.
When to call
An earlier discharge, a treatment change, a test result that changes the course of action, an unreachable patient, refusal of care: these are not sent as deferred writing, they are phoned.
We answer prescriber requests within the working day; we prefer a fast refusal to a polite silence.
What you receive from us, and when
A feasibility answer within the working day. A first handover note the day after the first visit. A written update at every change of condition, and a call whenever today's course of action must change.
We also anticipate prescription renewals about ten days before expiry, with the question stated in one sentence. A prescriber should never learn that a prescription has ended from an anxious patient.
What we will never do in your place
We do not adjust a dose without a written, signed protocol. We do not modify a prescription. We do not interpret laboratory results and we do not make diagnoses, even when the family asks.
That restraint is not excessive caution: it is the condition for a handover note keeping its value. An observer who interprets stops being a reliable observer.
Frequently asked questions on this page
How quickly can you start?
How do you receive prescriptions?
Do you take patients outside your area?
Can I obtain the full visit history?
How do you refer a patient outside the practice's area?
Do you accept requests through secure health messaging?
How do you handle a request that arrives at the weekend?
Can you take on a patient without a prescription in the meantime?
Terms explained
- Prescription
- A doctor's written order stating the procedure, frequency and duration. Without it, nursing care cannot be delivered or reimbursed, apart from procedures allowed in direct access.
- Handover notes
- The written record of a visit: what was done, what was observed, what must be watched. The shared memory of the care episode.
- Care protocol
- A written, dated description of how a specific patient's care must be delivered: products, supplies, frequency, alert criteria.
- MSSanté
- The French secure health messaging system, used to exchange health data between professionals, and with patients, outside ordinary email.
- Home hospitalisation (HAD)
- A structure delivering hospital-level care at the patient's home, with its own medical coordination.
- Nursing care assessment (BSI)
- A structured assessment of autonomy and needs for dependent people aged 90 and over, which replaces the former care plan and sets the daily care package.
- RPPS number
- The shared directory of health professionals: a unique, permanent and verifiable identifier for each professional.
Official sources
What we write is based on public references you can check for yourself.
This page is informational and replaces neither a medical consultation nor a prescription.