A referral system will function effectively if all service providers are expected to adhere to the referral discipline, to refer appropriately, and to follow the agreed protocols of care (where this system applies). It is the role of the supervising organization and facility supervisors to monitor referral statistics and to provide feedback as appropriate. The national health authorities (e.g. Ministry of Health) must expect the supervisors to regularly take action to ensure that the referral system progressively improves.
To achieve this level of consistent professional performance also requires appropriate education at medical and nursing schools and involvement of medical and nursing professional associations in setting standards for the referral processes.