You're referring a patient to a specialist. The letter needs to read like a clinician wrote it, contain the patient's relevant history, and arrive in the specialist's inbox today. The fax machine option is mercifully gone — almost.
Referral letters are short documents with high stakes. Get the format right.
Standard structure
Practice letterhead. Date. Recipient name and clinic. Patient identifiers (name, DOB, NHS or insurance number). Reason for referral in one paragraph. Relevant history in bullet points. Current medications. Examination findings. Investigations done. What you're asking for. Your signature and contact. Use a maintained Word template and convert to PDF for delivery.
Keep it scannable
Specialists triage referrals in seconds. Lead with the reason for referral, not the history. Bullet points beat prose. Bold the urgent flags. The specialist should know within ten seconds whether this is an urgent or routine referral. Format ruthlessly for the reader's time.
Sign and authenticate
For routine referrals, a typed signature is often acceptable. For urgent or high-risk referrals, use sign PDF for an authenticated signature with audit trail. The audit trail proves you wrote the referral; the specialist's office doesn't have to call to verify.
Secure delivery
Most referral pathways now use a secure portal or NHS e-Referral Service. Where a portal isn't available, password-protect the PDF and send via secure email. Patient information should never travel via unencrypted email. The audit trail of how you sent it matters as much as the content.
FAQ
Should I include all the patient's history or just what's relevant?
Just what's relevant to this referral. The specialist can request additional records if needed. Over-inclusion buries the key information.
Do I need a wet ink signature on referrals?
No — typed or electronic signatures are universally accepted on referrals. Wet ink is no longer the standard.
Can I share the referral with the patient?
Yes — patients are generally entitled to a copy of their referral. Some practices share by default to support patient engagement.
What's the safest way to email a referral?
Use NHS Mail or your equivalent secure email service. If using ordinary email, password-protect and send the password separately.
A clean referral letter goes from your desk to the specialist's hand the same day. Convert your Word template in Flint and the pathway works.