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How does cross-cover between specialties affect general practitioners and overall patient care? An audit of primary care referrals and secondary care investigations for patients with a history suggestive of renal colic

John Lloyd, Suneal Jugool, David Mclain

Many hospitals are reducing junior doctors’ hours with cross-cover between specialties. Rotas might be compliant but what effect does this have on patient care? A comparison study of 74 patients referred by general practitioners (GPs) with symptoms suggestive of renal colic was undertaken over a six-month period at the Royal Gwent Hospital, Newport, South Wales. Patients were either admitted under the new cross-covering general surgeons or directly under the urologists, and their treatment and follow-up compared. The study shows that GPs are very successful at diagnosing acute urological conditions, including renal colic. The urologists are significantly better than the general surgeons at investigating and arranging follow up for these patients. We recommend that changes be implemented to allow GPs to refer acute urological conditions to the urologists rather than a cross-covering speciality.