Too many patients fall into “referral black hole”

  • Date: 27 February 2023

A SURVEY from Healthwatch England found that around one in five patients with a primary care referral had to return to their GP having not been seen.

Healthwatch found that this "referral black hole" was due to one of the following:

  • referral to the wrong service
  • cancelled referral appointments
  • patients taken off waiting lists
  • patients hearing nothing more about their referral.

These meant that patients then had to go back to their GP to chase up referrals.

The online survey of 1,777 adults (18+) in England was commissioned by Healthwatch England and conducted by market research company Panelbase between 29 September to 21 October 2022. It found that 368 respondents had returned to their GP about the same symptom or condition because they had fallen into the "referrals black hole".

Healthwatch England is calling on government, NHS England and Integrated Care Systems (ICS) to do more to understand the referral process by gathering data on failures and looking for ways to ensure communication with patients is accessible, transparent and collaborative. It is also calling for the hiring/training of more care navigators - staff who can ensure people's needs are met in the right setting the first time.

Louise Ansari, National Director of Healthwatch England, commented on the survey findings: "The NHS knows a great deal about the difficulties people face getting a GP appointment and the current challenges with hospital waiting lists. But far less is known about people's experiences of getting a referral from the GP for more specialist care.

"Thousands of people have told us that the process can be far from straightforward, with a shocking number of people telling us their referral wasn't sent, got lost, or was turned down by the hospital without anyone letting them know.

"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."

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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