Training activity information
Details
Make referrals for individuals and/or families to other health or social care professionals
Type
Entrustable training activity (ETA)
Evidence requirements
Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion.
Reflection at multiple timepoints on the trainee learning journey for this activity.
Considerations
- Consideration of patient consent for referral
- Appropriateness of signposting and/or referral
- Professional boundaries
- Identifying patients at psychological risk for early intervention
- Referral pathways to other agencies e.g. screening facilities and support services
- Safeguarding children, young people and vulnerable adults
- Patient support services
- Professional standards, including:
- AGNC code of ethics
- GCRB code of conduct
- Good scientific practice
- HCPC standards of proficiency
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
What does success look like?
- You should identify what is expected of you in relation to identifying the need for and making appropriate referrals to other health or social care professionals.
- Review the relevant learning outcomes, specifically related to identifying opportunities to make referrals and in relation to practicing in accordance with standards when sharing confidential patient information during the referral process.
- Discuss what is expected of you, including the local process for making referrals and the criteria for selecting specific support agencies (e.g., patient organisation, psychological support).
What is your prior experience of this activity?
- Think about what you already know about identifying patient needs that require referral, different types of health/social care services, or the referral process.
- Consider possible challenges you might face during the activity, such as recognising a need outside your expertise, knowing which service is most appropriate, or overcoming patient reluctance to accept a referral, and think about how you might handle them.
- Recognise the scope of your own practice for this activity, i.e., know when you will need to seek advice or help and from whom, potentially seeking guidance from your supervisor or other team members regarding referral options or processes.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as assessing complex needs, knowledge of local/national referral pathways, or communicating effectively with other professionals and agencies, drawing upon previous experiences.
- Identify the specific insights you hope to gain from engaging with the activity, such as how different services contribute to patient care, the criteria for accessing specific support, or the benefits of integrated care.
What additional considerations do you need to make?
- Identify important information you need to consider before embarking on the activity, such as maintaining an up-to-date knowledge of available services, understanding referral criteria, and preparing necessary information for the referral.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst actively making or discussing the process of making a referral?
- Are you encountering situations such as:
- You encounter difficulties identifying the most appropriate service or contact person for the referral?
- The patient expresses reluctance or refusal to accept the referral you were recommending?
- You discover missing or incomplete information required to complete the referral documentation?
- There is an unexpected challenge in explaining the purpose or process of the referral to the patient or another professional?
How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to your explanation of the referral to address their reluctance or misunderstanding?
- Consider the steps you are taking in the moment, such as: Immediately seeking advice or clarification from a supervisor or colleague regarding the most appropriate service or adapting your explanation to address patient misunderstanding.
- How are you feeling in that moment? For instance, are you finding it difficult to initiate or complete the referral process efficiently? Is it affecting your confidence in identifying and recommending the appropriate referral pathway?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, were you able to successfully initiate or plan the referral by the end of the activity? Or are you needing support because the missing information requires contact with an external agency outside of standard operating procedure?
- What are you learning as a result of the unexpected development? For example, are you learning in the moment about the practicalities or potential psychosocial barriers in making referrals?
On action
What happened?
- Begin by summarising the key steps you took when identifying the need for, and initiating the process of, making a referral to an external agency (e.g., patient organisation or social care).
- Consider specific events, actions, or interactions which felt important, such as the difficulty you encountered when attempting to explain the referral process to a patient who demonstrated unexpected reluctance or resistance to accepting support.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately adapting your explanation to rephrase the benefit of the referral in terms of patient empowerment rather than deficit.
- How did you feel during this experience, e.g., did you feel focused on linking the patient to appropriate resources but frustrated by the logistical barriers or patient hesitation?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding referral pathways. What strengths did you demonstrate, e.g., accurate identification of a support need and knowledge of appropriate lay organisations?
- What skills and/or knowledge gaps were evident, e.g., difficulty confidently navigating patient reluctance or complex documentation requirements for identifying referrals?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in practicing in accordance with relevant standards regarding patient consent for referrals?
- Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding the documentation required when a patient explicitly refused a necessary referral to a psychological support agency, and how you reacted to this.
What will you take from the experience moving forward?
- Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to improving knowledge of the critical evaluation of patient support agencies and their specific referral criteria.
- What will you do differently next time you approach making a referral, for instance, by proactively providing written information about the intended service to manage patient expectations and reduce stigma?
- Do you need to practise any aspect of the activity further, such as explaining the benefits of social care referrals or key learning outcomes related to identifying opportunities to make referrals?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of coordinating external support since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how a subsequent patient having difficulty navigating an external support agency forced you to re-evaluate the level of detail provided regarding the referral process during your first attempt at this training activity.
- Considering what you understand about support networks, confidentiality, and collaborative care now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? How have you since implemented or adapted improvements in your referral process based on further learning and experiences? For example, how you proactively researched and integrated knowledge of relevant lay organisations and specialist psychological support networks to broaden your referral options.
- Has discussing patient reluctance to accept referrals or the impact of logistical barriers on accessing support with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how a patient who felt stigmatised by a social care referral refined your understanding of the critical nature of proactive communication to manage patient expectations and reduce perceived stigma.
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent referral identification and documentation experiences, contributed to your overall confidence and ability in holistic patient care and resource navigation? For example, how your accumulated ability in identifying a support need now enables you to confidently provide information about a relevant support agency during a DOPS assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to making referrals? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice immediately when a complex consent issue arises concerning data sharing for the referral, recognising this falls outside routine administrative scope.
- Looking holistically at your training journey, how has this initial referral experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to identifying opportunities to make referrals and practicing in accordance with relevant standards? For example, how this foundational experience has supported your development in practicing safely by providing the necessary knowledge base for the subsequent learning outcomes focused on using counselling supervision
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Identify opportunities to make referrals for individuals and/or families to other support agencies. |
| # 7 |
Outcome
Practice in accordance with the relevant standards. |