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Watchdog warns that NHS referral process has serious issues

A concerning report has emerged highlighting ‘serious issues’ with the NHS referral process following findings that one in five patient referrals made by GPs went into a ‘black hole’.

Healthwatch England who published the report stressed that it is often hard for some people to get a GP referral to another NHS service:

‘…for 21% of people we spoke to, even when they get referrals, they can be lost, rejected or not followed up on or sent back to general practice.’

The report goes on to say that ‘When services don’t process referrals properly, it can cause significant frustration, unnecessary anxiety, and even cause harm to patients.’

In detailing its findings they ‘…heard from 1,777 adults in England between September and October last year who had an experience of getting a GP referral within the previous 12 months. Of these, 368 (21%) fell into what we have called the “referrals black hole”.’

According to the findings, the failures were due to GP teams not sending referrals, referrals going missing between services, or being either booked or rejected by hospitals without any communication.

Louise Ansari, Healthwatch England’s national director said that thousands of people told the watchdog that the process is ‘far from straightforward.’

She said: ‘Falling into this “referrals black hole” is not just frustrating for patients but ultimately means people end up going back to their GP or visiting crowded A&E departments to get the help they need.

This adds more burden to already stretched services, making things even harder for the doctors and nurses trying to provide care.

Extra admin support must be put in place to improve referral processes and ensure that everyone who needs treatment can access it as quickly as possible, in the right setting and in a way that meets their needs.’

Read the full report here.

Delayed diagnosis and compromise in care

Gaps in care are not helped by growing concern over the imbalances between the increasing number of patients and the declining number of qualified doctors. According to NHS data taken from analysis by the House of Commons Library, the number of patients registered with a GP in England increased by more than four million, or 7 per cent, between December 2016 and December last year.

Meanwhile, the number of fully qualified full-time equivalent family doctors fell by 1,945, or 7 per cent, over the same period.


Several GP bodies are warning that the safety of patients is being compromised by the fact that family doctors are responsible for too many patients, with some parts of the country now having over 1000 patients per doctor.

Issues are being seen across the healthcare sector with significant shortages of nurses, doctors as well as midwives and paramedics and operating theatre staff – read our previous article: A&E Waiting Times Deteriorating

Medical Negligence Solicitors

As highlighted by the publication of these figures, more and more patients are experiencing delays in accessing appointments, treatment, or surgery. For those with time sensitive health issues, you must pursue your concerns with your NHS or private healthcare service provider urgently.

If you believe you or a loved one’s condition has been compromised by excessive waiting times or delays in your diagnosis and / or treatment you may be entitled to compensation.

At Bridge McFarland LLP our specialist medical negligence solicitors have assisted and continue to assist people concerning medical negligence claims surrounding failings in care and / or treatment received under the NHS and private healthcare sector.

To speak to our team, please call 0800 987 8800 or email