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Can a primary care nurse do a referral to a specialist eg neurologist?

I've seen on the board outside the GP practice listing all the doctors and nurses, a nurse with title Sister is that higher than a normal nurse? can a sister nurse do a referral to a hospital specialist? Does that mean that nurses are reluctant to refer unless a patent specifically asks to be referred?

Public Comments

1. Most practice nurses employed by the practice itself are at 'sister' grade. Generally as referrals however are generated by the GP.