Does mode of referral influence time to diagnosis?

By Dr Catherine Donaldson, Neurology Specialty Doctor, Southern Health NHS Foundation Trust


To identify areas within the service that could benefit from additional measures to improve efficiency and patient experience on the journey from referral to diagnosis.


The data collection project was initiated after the introduction of a Clinical Communication Gateway (CCG) electronic advice service for primary care.

It looked at the main referral sources, and whether the time to neuroimaging, assessment, and diagnosis was affected by referral route.

It also looked at the time from referral to commencement on disease modifying therapy (DMT), and treatment choices.

Key findings

  • In the year from September 2018, the service made 45 new diagnosis of MS.
  • The average time to diagnosis was 29 weeks for CCG referral, compared to 13.7 weeks for neurology consultant referral
  • Of those who started on DMT, the average time from diagnosis to treatment initiation was 28.5 weeks (range: 7.5 to 70 weeks).
  • The original source for the majority of new diagnoses was CCG (26.6%)


The time to diagnoses was shortest where made via a neurology referral. While this can, at least in part, be explained by the fact that many of the investigations would have already been completed in this scenario, the significant variation requires consideration.

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