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Background: Outcomes for colorectal cancer patients vary significantly. Compared to other countries, Australia has a good record with patient outcomes, yet there is little information available on the referral pathway. This paper explores the views of Australian patients and their experiences of referral for colorectal cancer treatment following diagnosis; the aim was to improve our understanding of the referral pathway and guide the development of future interventions. Methods: A purposive sampling strategy was used, recruiting 29 patients representing urban and rural areas from 3 Australian states who participated in 4 focus groups. Seven patients provided individual interviews to supplement the data. Recordings were transcribed verbatim, data was coded with NVivo software and analysed thematically before deductive analysis. Results: Four aspects of the referral process were identified by patients, namely detection/diagnosis, referral for initial treatment/specialist care, the roles of the GP/specialist, and the patient's perceived involvement in the process. The referral process was characterised by a lack of patient involvement, with few examples of shared decision-making and few examples of limited choice. However, patients did not always feel they had the knowledge to make informed decisions. Information exchange was highly valued by patients when it occurred, and it increased their satisfaction with the process. Other factors mediating care included the use of the public versus private health system, the quality of information exchange (GP to specialist and GP to patient), continuity of care between GP and specialist, and the extent of information provision when patients moved between specialist and GP care. Conclusions: Patients described poor GP continuity, ad hoc organisational systems and limited information exchange, at both interpersonal and inter-organisational levels, all leading to sub-optimal care. Implementation of a system of information feedback to GPs and engagement with them might improve information exchange for patients, enabling them to be more involved in improved referral outcomes. [ABSTRACT FROM AUTHOR]

Access to consultations with general practitioners (GPs) is an important health policy issue. One method of providing 24-hour access is through the provision of open-access surgeries. The study aimed to compare patients' perceptions of 'bookable' and 'non-bookable' (open-access) appointments. A cross-sectional survey design was used and recruited 834 patients in a general practice. There were statistically significant differences between the bookable and the non-bookable appointments for the questions on 'choice of doctor', 'whether able to see the doctor in the time they needed to', and 'convenience of the appointment'. More patients with bookable appointments saw their doctor of choice. One-fifth of patients, equally distributed between the two groups, did not feel that they were seen within the time they needed to be. Almost three-fifths of patients, equally distributed between the two groups, reported that it was either 'easy' or 'very easy' to make the appointment. Greater convenience was reported by those with bookable appointments. These findings support the hypothesis that within a single practice, there is scope for a combined appointment system in which patients can self-select, with equal satisfaction, the type of appointment that they prefer, dependent upon their own preferences or needs at the time.