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"Because of the sheer volume of referrals, finite resources and other external limitations," the report said, "we cannot investigate all of the referrals we receive concerning distance-education fraud rings".
Concerned at the increasing volume of referrals of pre-school children with autistic features, she drew on the research of the psychoanalyst Wilfred Bion, who emphasised language development as an aspect of a broad process concerned with enabling emotional experience to become thought.
The Stark Law restrictions on physician self-referral were intended to avoid the financial incentives for physicians to increase the volume of referrals for ancillary services, particularly with physician ownership of imaging service capacity [7 17].
"Due to the high volume of referrals resulting from recent publicity in the BBC and national press, the clinic is not accepting new patients in order that we can deal with the patients already referred".
The volume of referrals, which ranged from just over 5000 to 7000 patients in 2014, presents a challenge for these clinics.
However, the evidence in this regard is as yet inconclusive, and it had been suggested that inappropriate use of such a service could increase delay as a consequence of an increased volume of referrals.
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Since the capital investment required is considerable, this option is feasible only for firms able to generate a volume of referral business large enough to justify the investment.
To a certain extent, they may also influence the volume of referral health care.
We will therefore examine potential contamination effects by comparing the appropriateness and volume of referral between groups for the first ten MoleMate consultations of each Lead Clinician's data collection when contamination would be minimal ('naive period'), with the remaining consultations ('potentially contaminated period').
We did not adjust costs by practice size or by volume of referral because (1) the advocate educator salary costs were fixed at the start and (2) the practices that referred disproportionately fewer women, with a smaller impact on advocate caseload required greater training and support input to encourage increased engagement with the programme, increasing the workload of the advocate.
"The department now needs to demonstrate that, in the face of changes in the volumes of referrals to the programme and changes in economic conditions, it can still hold prime contractors to the delivery promises they made," the report says.
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