Referrals are meant to improve care of patients whose treatment cannot be continued in a health facility with less technological expertise or where virtually health service rendered cannot exceed mere pain or symptomatic management.

Referral is an integral component of the health delivery system of the country as it seeks to ensure continuous provision of health care from the primary care levels. Due to inadequate resources at these levels there is a need for harmonization of the referral system and standard procedures that define rules and responsibilities of the referring and receiving health facilities.

Non adherence to these obligations affects the continuous and seamless delivery of health care to the patient. The current practice is that patient referrals most of the times cause delays in accessing critical or emergency care and eventually leading to preventable deaths, these challenges facing the referral system in the health sector are key reasons to bring about increase access to health care by all people in Ghana, especially for the ministry of health visions of creating a healthy population for national development.

The commitment in operating a referral system that will ensure safe and efficient transfer and care of patients within its health facilities is paramount.

It is important to acknowledge that harmonization of the referral system will allow for better collaboration and communication between health facilities. This will contribute to the reduction of the challenges affecting smooth and responsive patient referrals.

There is the need to build and improve confidence in the referral system in the country and ensure efficient healthcare delivery. Adherence to policies of referrals should be enforced so that all public and accredited private health facilities will follow suit and shall develop operational policies to facilitate its implementation.

From the Ministry of Health all health care provider shall refer patients appropriately to ensure continuous provision between all levels of health care in the country.

The current situation

The norm is patients will first have to access the primary care before they are referred to the appropriate level when the need ensues but due to ignorance, inadequate primary health care facilities and possible lack of confidence in the first level facilities.

The inefficiencies of the referral system are probably due to factors such as lack of standard procedures for referrals, delays in referrals, non-use of referral forms, poor perception of the system by referral patients and lack of feedback. If these factors are not addressed it may result in high healthcare costs to mutual health schemes and their eventual collapse.

Referrals per ministry of health involves the transfer of some or all responsibility for the patient care temporarily or permanently and for a particular purpose such as investigation, consultation, care or treatment of the patient. It ensures that patients can access care at the primary (lower) levels and be referred promptly for secondary or tertiary care if required.

Referrals back to the lower facility are recommended when the reason of referral has been addressed. Referral involves co-operation, co-ordination, and information transfer between the various service deliveries.