Introduction
A referral is a request to add a patient to another team's care. When you refer a patient, you're inviting another team to share responsibility for the patient's care, provide a specialist consultation, or take over care entirely. Unlike handovers (which transfer responsibility between individual clinicians), referrals operate at the team level and require the receiving team to accept or reject the request.
Before You Start
To send a referral, you must be a member of at least one team that is currently caring for the patient. Any member of the receiving team can accept or reject incoming referrals.
How Referrals Work
Sending a Referral
Referrals are sent from the patient's profile:
- Navigate to the patient's profile page
- Click the kebab menu (⋮) in the header
- Select Refer Patient to Team
- In the dialog that appears, select the source team (if the patient is on multiple teams) and target team
- Add a Reason for Referral — this is optional but strongly recommended. The system suggests using SBAR format (Situation, Background, Assessment, Recommendation)
- Attach any relevant files if needed
- Click Submit
The referral request now appears in the Referrals tab of the receiving team's team view.
Receiving and Responding to Referrals
When a team receives a referral, any team member can respond:
- From the sidebar, select Teams and choose your team
- Click the Referrals tab
- Review the Referrals Received section — you'll see the patient name, source team, referral reason, and any attachments
- Click Accept to add the patient to your team, or Reject to decline
What happens when you accept a referral:
- The patient is added to your team's patient list
- You automatically become the responsible clinician for that patient (unless you already have responsibility)
- A clinical note is created documenting the referral, including any attachments and the referral reason
- The referral is removed from both teams' referral lists
If you reject a referral:
- The referral is permanently declined and removed
- The patient remains only with the original team
- The sending team is notified of the rejection
Cancelling a Sent Referral
Before a referral is accepted or rejected, the sending team can cancel it:
- Navigate to your team view
- Click the Referrals tab
- In the Referrals Sent section, find the referral
- Click Cancel
The referral is withdrawn and removed from both teams' views.
Referral vs Transfer vs Handover
CAREFUL has three distinct ways to move patient care:
Referral — Team-to-team request to share care or consult
- Patient may stay with both teams (shared care)
- Requires acceptance by receiving team
- Does NOT automatically transfer actions between teams
- Used for: consultations, adding specialist input, shared care arrangements
Transfer — Automatic referral with discharge (explained below)
- Patient moves from one team to another in a single step
- Used when you're a member of both teams
- Automatically discharges patient from the source team
Handover — Clinician-to-clinician transfer of responsibility
- Transfers individual responsibility within or across teams
- Can handle multiple patients at once
- Automatically reassigns all associated actions to the receiving clinician
How to Transfer a Patient (Referral + Discharge)
If you need to move a patient completely from one team to another — rather than sharing care — you have two options:
Option A: Manual Transfer (Standard Workflow)
- Send a referral (as described above)
- Wait for the receiving team to accept
- Once accepted, handover any outstanding actions to a member of the receiving team
- Return to the patient's profile
- Click the kebab menu (⋮)
- Select Discharge from team
- Choose the original team and confirm
This is the recommended workflow when teams don't share members, as it ensures actions are properly transferred.
Option B: Automatic Transfer (If You're in Both Teams)
If you are a member of BOTH the source and target teams, you can complete the transfer in one step:
- Navigate to the patient's profile
- Click the kebab menu (⋮) and select Refer Patient to Team
- Select the source and target teams
- Check the box labelled "Transfer Immediately? (This will ACCEPT the referral request and DISCHARGE from sending team)"
- Add a reason for the transfer
- Click Submit
What happens:
- The referral is created and immediately accepted
- The patient is added to the target team
- You take responsibility for the patient on the new team
- The patient is automatically discharged from the source team
- A clinical note documents the transfer
Important: This option is only available when you are a member of both teams. It's most commonly used for transfers within closely-related teams (e.g., from one ward to another, or between sub-specialities).
Important Differences from Handover
-
Referrals do NOT transfer actions. When a referral is accepted, the patient joins the new team, but any outstanding actions remain assigned to their original owners. If you're transferring a patient completely to another team, you should handover actions separately before discharging from the original team.
-
Referrals can be rejected. The receiving team has the choice to decline. Handovers, once sent, must be accepted or rejected by the specific recipient.
-
Referrals are team-level. Any member of the receiving team can accept a referral. Handovers are sent to specific individuals.
Tips
- Always include a clear Reason for Referral — this helps the receiving team understand what input you need and becomes part of the patient's permanent clinical record
- Use the SBAR format (Situation, Background, Assessment, Recommendation) for comprehensive referral notes
- Attach relevant documents, images, or test results directly to the referral
- If you're transferring care completely, consider whether you need to handover actions before discharging the patient from the original team
- Check the Referrals tab regularly to respond to incoming requests promptly
- For same-day transfers within your organisation (where you're in both teams), use the "Transfer Immediately?" option to streamline the process