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The purpose of this paper is to address the following research question: What are the perceptions of professionals and consumers regarding the antecedents of client referrals in the financial advice sector?

A total of 61 qualitative interviews were conducted, with the following three key groups: independent financial advisers (IFAs; 20 interviews), clients of IFAs (26 interviews) and consumers who manage their own financial affairs and do not use the services of an IFA (15 interviews).

The financial advisers interviewed believe that client referrals are important to their business success, that they can influence clients to become ambassadors who will consciously seek out new clients and that excellent service will motivate clients to provide referrals. However, the interviews with the clients painted a different picture. While advisers believe that they can influence client referral behavior, the clients did not believe that they were influenced by the adviser to make referrals.

The sampling method was non-random and relied on the professional contacts of the principal researcher as a starting point, from which a network of contacts was established to identify interviewees. The study casts doubt on the ability of professional service providers to influence client referral behavior. This novel finding deserves further research investigation.

There is clearly scope for greater measurement in connection with referrals in professional service businesses. The propensity for clients to refer should be included as a metric in the performance measurement of professional service providers, in addition to standard financial measures. This would encourage the service provider to consider referrals during client interactions.

The study reports on a substantial qualitative study involving both professional service providers and their clients. While the providers believe that client referrals are critical to their business success, the evidence collected provides little or no support for this belief. Clients report they are not motivated to refer. Advisers do not explicitly measure referrals. The reality of referrals seems not to match the mythology.

The Leeds Autism Diagnostic Service (LADS) is an all IQ service accepting professional and self-referrals, from age 18, for diagnostic assessment. LADS is unusual compared to other diagnostic services in England, in that it accepts self-referrals. The purpose of this paper is to compare diagnostic outcome between self-referrals and other referral sources.

This is a service evaluation of all 692 referrals for diagnostic assessment into LADS, over a three year period, from 2016 to 2018. The diagnostic outcomes were compared between self-referrals and other referral sources. Secondary analysis looked at age and gender differences between these groups.

There were 98 self-referrals over three years with autism diagnosed in 65 per cent. In total, 594 other referrals were received during this time period, with autism diagnosed in 44 per cent. This showed a significant difference of 21 per cent with 95% confidence intervals of 10–31 per cent (p=0.0001) using a n−1 χ² test. In total, 59 per cent of self-referrals were from patients identifying as female, which compared to 35 per cent identifying as female from other referrals. This was a difference of 24 per cent with 95% confidence interval of 14–34 per cent (p<0.0001) on the n−1 χ² test.

Factors which may influence the ability to generalise from these results are: that LADS covers a large mainly urban and suburban area with a range of ethnic and socioeconomic diversity; that LADS is an all IQ service unlike some other autism diagnostic services; historical and service-related factors unique to Leeds may be dissimilar to other locations. It was beyond the scope of this evaluation to perform a qualitative analysis to compare the referral sources, but this may be an area for further study.

This evaluation supports the use of a self-referral route for adult autism diagnostic services on a local level and may support its use more widely in other services.

This evaluation, in demonstrating proportionately significantly higher autism diagnosis from self-referrals is likely to be reducing the work load of professionals who would normally make referrals. Alternatively, it may be capturing a subgroup of the autism population who would not otherwise have sought diagnosis. In either scenario, it supports and is consistent with a patient centred approach to accessing appropriate diagnostic services.

The authors are not aware that any previous evaluation of this nature has been conducted and feel this evaluation supports the use of a self-referral pathway in adult autism diagnostic services.

Highlights the need for professionals who refer customers among themselves to acquire up‐to‐date information on specialists available in the area and their performance. Develops a model to assist with the understanding of this process. Discusses several managerial implications related to marketing referrals. Concludes that further investigations of the model are needed in other service markets.

Recent evidence on consumer decision-making suggests that highly complex choice scenarios lead consumers to use simplistic decision heuristics, often resulting in suboptimal decision-making. This study aims to investigate the relationships among consumers’ primary information source, patient satisfaction and patient well-being, specifically focused on the search for mental health professionals. The selection of a mental health provider is of interest, because practitioners work from a highly diverse set of theoretical bases, may hold a wide range of different credentials and provide drastically different therapeutic approaches, therefore making the selection complex and difficult for consumers to self-navigate.

Three studies were undertaken, with data sampling from both patients of mental health services and practitioners.

Consumers selecting a provider based on self-performed searches, rather than receiving external input (referrals from physicians, relatives or friends), report lower satisfaction with their mental health provider. In turn, patient satisfaction positively impacts patient well-being. Practitioner data corroborate these findings, revealing that a large percentage of patients stem from a self-performed internet search, though mental health providers recognize that external referrals are likely to lead to better outcomes.

The results reveal the importance of understanding the consumer search and, particularly, the use of the internet as a search tool. The results present several implications for service providers, including the need to identify patients’ primary source utilized within an information search, as it can adversely impact patient satisfaction.

The purpose of this paper is to evaluate how the intermediation of an online agent in the relationship between prospective clients and professional service providers affects individual purchasing processes and decisions, and satisfaction with the professional service provider once the commercial transaction is concluded.

Drawing on the integrated trust-technology acceptance model, modified to include two additional variables to take into account of the specificities of the context investigated – users’ perceived reduction of information asymmetry and satisfaction with the professional service provider – a research framework is developed and tested with a research design combining a decision tree procedure with structural equation modelling and multi-group analysis. Participants are 188 users of an Italian website which incorporates an online agent that refers notaries to prospective clients.

Decisions to purchase professional services brokered by online agents depend upon trust in the agent, and users’ perceptions of the agent’s ability to reduce information asymmetry, as well as its perceived usefulness. Online agents for professional services can be effective as well as efficient: users who bought the service from an agent-referred notary had higher levels of satisfaction with their professional service provider than users who purchased the service from a different notary.

This is the first empirical effort to investigate the effects of online agents in the specific context of professional service purchasing. The uniqueness of the research context permitted identification of a new type of online agent, the “double-sided online referral agent”.

The purpose of this paper is to address a critical problem for health-care organizations: patient referral leakage. This paper explores the nature of patient referrals by examining how health-care providers’ breadth and depth of connectivity within a hospital network and identification with each other influence the likelihood of future patient referrals.

The data was collected by using a multi-sourced data set from the health-care industry. The proposed model was tested by using logistic regression to determine the likelihood of a primary care physician’s (PCP) referral to a specialist within a hospital network.

A model linking provider connectivity to examine co-creation practices in the form of patient referrals is tested. Results indicate that patient referrals are multidimensional. A PCP’s likelihood to refer to a specialist within the hospital network is influenced by the breadth and depth of connectivity of each provider.

This investigation extends service ecosystems to patients, health-care providers and hospital organizations, making it the first to explore how different degrees of connectivity (breadth of referral partners and depth of exchange) between and among health-care providers influence the likelihood of future patient referrals. Findings complement extant literature on service ecosystems by empirically showing that provider relationships are interdependent and rely on the mutual coordination of benefits within the entire health-care organization and network.

Managers and health-care professionals can use the framework to build and strengthen relational ties/alliances within a service organization. An ecosystems perspective reduces patient referral leakage through enhanced organizational performance, competitive advantage and continuity of care.

The authors offer a novel view of referral relationships using hard-to-access proprietary data. Moreover, this study responds to the need for transformative service research by offering service researchers and policymakers a means to enhance consumer well-being. The main contribution of this study is a framework to gain a better understanding of patient referral relationships between employees (i.e., health-care providers) in an organization, thereby affording an opportunity to bolster operational efficiencies, improve clinical outcomes and strengthen referral pathways. By viewing health-care networks through a service ecosystems perspective, contextual boundaries and the relative power of relationships are also identified. The novel use of rarely available hospital data in this setting helps explain how patient leakage compromises the health of the ecosystem and its members.

The most cost‐effective of all marketing tools is substantially ignored by those organizations which could most benefit from its application – professional services. The interpersonal network (referrals) provides in excess of 80 per cent of new clients coming to a practice, yet few firms consciously seek to make it more efficient. A coherent and consistent operational plan to ensure the system actively works for the organization is within easy reach of all firms.

This paper aims to respond to the findings of the initial phase of the Safeguarding Adults Programme (November 2009‐March 2010), which found an unexpected inverse relationship between referral rate for safeguarding adults and population size of local authority in the data captured from April 2008 to March 2009.

An analysis of regional safeguarding referral rates relative to population with a breakdown by service groups was undertaken; statistics from the economic deprivation index (EDI) were also used. A questionnaire was designed and sent out to the authorities regarding thresholds, eligibility, definitions, advice and information available to referrers, accuracy of recording and public awareness. The data analysed here cover the following year's safeguarding referrals.

The questionnaire revealed broad differences in thresholds, eligibility, definitions, advice and information available to referrers, accuracy of recording and public awareness campaigns across the studied authorities. These differences contribute to obscuring real differences in underlying processes. A highly significant relationship between EDI and safeguarding referral rates was found, implying real differences in abuse rates driven by underlying socio‐economic factors. Differences in abuse allegations were systematic, so that authorities with a particularly high level of referrals did not have unusually high contributions from particular service user groups or from particular referral sources. Similarly the nature of abuse allegations did not differ between authorities with high or low‐referral rates.

The paper investigates the reasons for variation and explores thresholds for safeguarding referrals.

Collaborative inter-agency working is of paramount importance for the public protection agenda worldwide. The purpose of this paper is to disseminate the findings from a research study on the inter-agency working within adult support and protection (ASP) roles in the police, health and social care.

This realistic evaluation study with two inter-related phases was funded by the Scottish Institute for Policing Research. This paper reports on Phase 1 which identified existing gaps in the implementation of effective inter-agency practice by reviewing the “state of play” in inter-agency collaboration between the police and health and social care professionals. In total, 13 focus groups comprising representatives from Police Scotland (n=52), Social Care (n=31) and Health (n=18), engaged in single profession and mixed profession groups addressing issues including referral and information exchange.

On analysing context-mechanism-outcome (CMO), gaps in joint working were identified and attributed to the professionals’ own understanding of inter-agency working and the expectations of partner agencies. It recommended the need for further research and inter-agency training on public protection.

This unique Scottish study successfully identified the inter-agency practices of health, social services and police. By means of a modified realistic evaluation approach, it provides an in-depth understanding of the challenges that professionals face on a day-to-day basis when safeguarding adults and informed strategic recommendations to overcome the barriers to good practices in organisational working. The methods used to determine CMO could benefit other researchers to develop studies exploring the complexities of multi-causal effects of cross-boundary working. The use of the same case study in each focus group helped to neutralise bias. However, the voluntary nature of participation could have resulted in biased perceptions. The limited numbers of health professionals may have resulted in less representation of health sector views.

This paper reports on a Scottish study that focused on the coordinated and integrated practices amongst the police, health and social services’ professionals who support and protect adult members of society at risk of harm and has implications for their practice.

Whilst the focus of this study has been on ASP, the conclusions and recommendations are transferable to public protection issues in many other contexts.

Studies on the joint-working practices amongst police and health and social services’ professionals who support and protect adult members of society at risk of harm are uncommon. This study investigated professionals’ perceptions of gaps and concerns pertaining to integrated working by means of a realistic evaluation approach. It recommended the need for further research and inter-agency training on public protection.

Professional service organizations are finding themselves increasingly involved with marketing in order to develop and maintain relationships with their clients. Restricted by professional standards, and hindered by a lack of experience, firms are struggling to understand marketing and implement marketing programs. Nowhere is this struggle more evident that in the accounting profession, where firms are regulated by professional standards and guidelines. Based on a series of one‐on‐one interviews with accounting professionals, American Institute of Certified Public Accountants standards and guidelines, and information from both practitioner and academic literature, this research identifies the extent to which firms are following the prescriptive advice. Discussions of initiatives are provided as guidelines for further implementation of marketing strategies in the accounting profession and other professional service firms that are following in the accountants’ footsteps.