Purpose: We analysed patterns of interhospital referrals to the Royal Brisbane and Women’s Hospital (RBWH) Neurosurgical Department using the unique electronic referral system Hospital Emergency Neurosurgical Referral Interface (HENRI) in its first year, with a focus on traumatic presentations. Methodology: Demographic, clinical and outcome data from patients referred to the RBWH Neurosurgical Department between February 2021 and February 2022 were extracted from HENRI and analysed. Results: During this period, 3791 referrals from 37 hospitals were received. 30% of cranial referrals were for traumatic brain injury (TBI). Spinal fractures (SF) made up 60.8% of spinal pathology. The median age was 69 years overall, 73 years for TBI and 70 years for SF. 20% of TBI and 9.1% of SF were marked as urgent (0-1 hours) compared to 17% of all referrals, however only 13% of all referred patients required transfer to the RBWH, with even fewer for TBI (8%) and SF (4%). The median time between referral and surgery was 61 hours overall, 43 hours for TBI and 81 hours for SF. Neurosurgical involvement was not indicated in 47% of TBI, 46% of SF, and 37% of all referrals. Overall, 24% of referrals were managed at local hospitals with neurosurgical advice, 28% for TBI and 26% of SF. 25% of patients were on an antiplatelet and 22% were on an anticoagulant. Conclusion: A significant volume of neurotrauma is being managed by generalists in regional and rural hospitals. Many of these patients are elderly with iatrogenic coagulation abnormalities. This highlights the need for further education for referring clinicians to both reduce inappropriate referrals and improve confidence in the management of neurosurgical trauma at peripheral sites.