Existing methodologies for triaging referrals in orthotic services and wider allied health professional settings: A scoping review

This scoping review aims to establish an understanding of existing tools or methodologies to grade referral quality or appropriateness published in an orthotics, Allied Health Profession (AHP), or AHP-involved setting. All patients deserve equal access to NHS services, but without knowing if services accept and triage referrals in the same way, it is not possible to. The PRISMA (ScR) checklist was used to structure this scoping review. The search was performed on March 04th, 2025, and was restricted to publications in the English Language only. Publications were screened and extracted by a single reviewer. Further to the literature search a call for gray literature, unpublished service evaluations, or audits through the British Association of Prosthetists and Orthotists, 71 publications were found, and 19 of these were included in the review. No publications focused on an orthotics setting, and only 3 publications centered on AHP specific services. Large variations exist in the methodology used and the purpose of evaluating referrals, with the 2 key tests of appropriateness appearing to be clinicians’ judgment or on the outcome after a referral. There is a gap that appears to exist wider than the orthotics profession in what is considered an appropriate referral and an agreed upon methodology for measuring appropriateness. This could be a valuable topic for further research and consideration, with the initial steps being to establish an understanding of how orthotic departments receive and evaluate referrals and understanding if there are differences in experience or common problems that services face.