GP referrals to specialist services must be taken seriously, says College Chair

Responding to research from Healthwatch England that found GP referrals to specialists have been rejected, cancelled or lost by hospitals, Professor Kamila Hawthorne, Chair of the Royal College of GPs said: "GPs take their responsibility to refer appropriately and in a timely way very seriously. When doing so they will take into account the various factors impacting on a patient's health, their family and medical history and clinical guidelines, as well as pressures on local onward services. It is a professional letter that is written carefully and thoughtfully. With this in mind, it's essential that GP referrals made to specialist care are taken seriously and not rejected without a very good reason.

"Often patients might want a referral, but the GP might not consider this the most clinically appropriate course of action - either because their condition might be treatable in general practice, or because on balance of risk, a referral to specialist services is not necessary. And GPs will do their best to explain this reasoning to a patient. Sometimes, inappropriate referrals can be both unnecessary for the patient and wasteful of NHS resources.

"If a patient has been told a referral will be made, but for whatever reason it is not, or it gets lost or the patient doesn't hear about it, then this needs to be addressed as it could have a negative impact on the health of the patient and in the longer term, the wider health service. Most GP practices have measures in place to make sure referrals are not missed. Sometimes the referral may go to the wrong place, especially if the referral destination has changed. With current backlogs in the NHS it is quite possible for patients to be waiting for many months to be seen, and that can result in additional GP appointments by worried patients checking up on their referral status.

"GPs and our teams are currently working under intense workload and workforce pressures. Last year, 340m patient consultations were made, almost 9% higher than in 2019, and that increase in workload is partially due to delivering interim care to patients on waiting lists. It is in everybody's best interests, particularly patients’, that referral processes are working efficiently. We would agree with Healthwatch that the government needs to further invest in expanding the number of GPs as well as more administrative staff in general practice, such as care navigators."

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Notes to editor

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.