RT Journal Article SR Electronic T1 Receptionist rECognition and rEferral of Patients with Stroke (RECEPTS): unannounced simulated patient telephone call study in primary care JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP e421 OP e427 DO 10.3399/bjgp15X685621 VO 65 IS 636 A1 Ruth M Mellor A1 James P Sheppard A1 Elizabeth Bates A1 George Bouliotis A1 Janet Jones A1 Satinder Singh A1 John Skelton A1 Connie Wiskin A1 Richard J McManus YR 2015 UL http://bjgp.org/content/65/636/e421.abstract AB Background Stroke is a leading cause of morbidity and mortality. Timely recognition and referral are essential for treatment.Aim To examine the ability of receptionists in general practices to recognise symptoms of stroke and direct patients to emergency care.Design and setting Unannounced simulated patient telephone calls and prospective cross-sectional survey study in general practices in the Birmingham and Solihull area.Method A total of 52 general practices participated in a total of 520 simulated telephone calls, with 183 receptionists completing questionnaires. Logistic regression analyses were used to examine likelihood of referral for immediate care by ease of vignette recognition and number of common stroke symptoms present.Results General practice receptionists correctly referred 69% of simulated calls for immediate care. Calls classed as ‘difficult’ to recognise were less likely to be immediately referred. Compared with ‘easy’ calls: ‘difficult’ calls odds ratio (OR) 0.15, 95% confidence interval (CI) = 0.08 to 0.26; ‘moderate’ calls OR 0.55, 95% CI = 0.32 to 0.92. Similarly, calls including one or two ‘FAST’ symptoms were less likely to be referred immediately (compared with three FAST symptoms: one symptom OR 0.30, 95% CI = 0.13 to 0.72; two symptoms OR 0.35, 95% CI = 0.15 to 0.83).Conclusion General practice receptionists refer patients with stroke for immediate care when they present with several symptoms; however, they are less likely to refer patients presenting with only one symptom or less common symptoms of stroke. Optimum management of acute stroke in primary care requires interventions that improve receptionists’ knowledge of lesser-known stroke symptoms.