Mariken Stegmann

Abstract Introduction: To provide optimal care for patients with cancer, timely and efficient  communication between healthcare providers is essential. In this study, we aimed to achieve  consensus regarding the desired content of communication between general practitioners  (GPs) and oncology specialists before and during the initial treatment of cancer.  Methods: In a two‐round Delphi procedure, three expert panels reviewed items  recommended for inclusion on referral and specialist letters.  Results : The three panels comprised 39 GPs (42%), 42 oncology specialists (41%) (i.e.,  oncologists, radiotherapists, urologists and surgeons) and 18 patients or patient  representatives (69%). Final agreement was by consensus, with 12 and 35 items included in  the GP referral and the specialist letters, respectively. The key requirements of GP referral  letters were that they should be limited to medical facts, a short summary of symptoms and  abnormal findings, and the reason for referral. There was a similar requirement for letters  from specialists to include these same medical facts, but detailed information was also  required about the diagnosis, treatment options and chosen treatment. After two rounds,  the overall Content Validity Index (CVI) for both letters was 71%, indicating that a third  round was not necessary.  Discussion: This is the first study to differentiate between essential and redundant  information in GP referral and specialist letters, and the findings could be used to improve  communication between primary and secondary care.  82 Chapter 7