Referrals are made by visitors, friends, family, neighbours, solicitors/immigration advisers, and by detainees themselves.

Case co-ordinators complete the referral form and liaise between the detainee and MJ Referrals Manager – this can be done by the original referrer or someone else.

Some case co-ordinators work closely with the solicitor and the clinician.

The MJ Referrals Manager tries to ensure that the referral form is reasonably complete before forwarding it to the clinician -  also establishes if funding is available and if an interpreter will be necessary.

The clinician accepts the referral and suggests a date for a visit.

It may be necessary to write a Time To Examine letter to ask for e.g. a hearing to be adjourned so that there is enough time for an MLR to be prepared.

Most IRCs only offer the necessary facilities for a medical consultation during fairly restricted hours, often a 2-3 hour slot in the morning and another in the afternoon.

The Referrals Manager faxes a request for an appointment to Healthcare and phones to confirm it.

The Referrals Manager arranges for the detainee to go to Healthcare to sign the necessary authorization form for the visit.

How long it takes to get into each IRC varies, admission procedures such as the ID check, search, etc may be slow so it can be useful to arrive up to 30 minutes early to maximise the time spent with the patient (esp. if more than one consultation).

Doctors need to bring their GMC registration certificate with them for the first visit.

Consultation for an MLR may take 1½ hours or more.

Let patient know approximately how long it is likely to be before their report will be ready - within 1 week is ideal though it may take longer.

Some patients will not need full MLRs.

A Rule 35 letter may be needed.

A complaint may be needed - more info  

Check the draft MLR with the patient and/or patient’s solicitor – the case co-ordinator, or in some cases the Referrals Manager, or clinician can do this.

Email/fax MLR and/or other correspondence to the solicitor with a copy for the Referrals Manager.

When funding is available, the clinician invoices the solicitor.

Clinician returns audit form.

Case co-ordinator should update MJ on progress.

Follow up work is likely to be needed for ongoing medical issues.