Key Takeaways:
- One in seven people in England who need hospital care are not receiving it due to lost, rejected, or delayed GP referrals.
- 75% of those affected suffer harm to their physical or mental health as a result of not being added to the waiting list for tests or treatment.
- 70% of patients only discover that their referral has not been processed after chasing up the NHS.
- 14% of all referrals are getting "stuck" between GPs and hospitals, leaving patients in the dark and anxious about when they will be seen and treated.
- The NHS waiting list may not accurately reflect the number of people who need care, with 6.24 million people waiting for 7.39 million tests or treatments.
Introduction to the Problem
The NHS’s patient watchdog, Healthwatch England, has found that one in seven people in England who need hospital care are not receiving it because their GP referral is lost, rejected, or delayed. This "referrals black hole" affects a significant number of patients, with 75% of those trapped in this situation suffering harm to their physical or mental health. The lack of communication with patients is a significant issue, with 70% of patients only discovering that their referral has not been processed after chasing up the NHS. This lack of transparency and accountability can lead to increased anxiety and stress for patients, who are already vulnerable due to their health conditions.
The Scale of the Problem
The research found that 14% of all referrals are getting "stuck" between GPs and hospitals, leaving patients in the dark and anxious about when they will be seen and treated. This can have serious consequences, with patients experiencing delays in diagnosis and treatment, which can worsen their condition. The NHS waiting list, which currently stands at 6.24 million people waiting for 7.39 million tests or treatments, may not accurately reflect the number of people who need care. The fact that 14% of referrals are not being processed means that many patients are not even being added to the waiting list, let alone receiving the care they need.
Patient Experiences
The report highlights the human cost of these delays, with patients experiencing pain, stress, and uncertainty. One patient, Patrick, 70, an ex-NHS worker from Milton Keynes, has been waiting since July to see a specialist about pain in his hip and back. Despite his GP referring him, he has heard nothing about when he will be seen, and his pain has become so bad that he struggles with daily tasks. His experience is not unique, with many patients reporting similar experiences of delays and poor communication. The emotional toll of these delays should not be underestimated, with patients feeling like they are "existing not living" due to the uncertainty and lack of control over their care.
Response from Healthcare Leaders
The findings have been described as "deeply alarming" by the chief executive of the Patients Association, Rachel Power. She highlights the need for improved communication and transparency, stating that patients should not have to chase up their referrals to find out what is happening. The Department of Health and Social Care (DHSC) has acknowledged that the situation is "not acceptable" and has outlined steps being taken to address the issue. These include the introduction of Jess’s rule, which requires GPs to seek a second opinion if they cannot diagnose a patient’s illness after three appointments. Additionally, the DHSC is investing an extra £1.1bn in general practice and recruiting more family doctors to reduce waiting times.
Progress and Improvements
Despite the challenges, there are signs of progress. The number of patients whose referrals get lost, rejected, or denied has decreased from 21% to 14% since similar research was undertaken in 2023. The introduction of the NHS app has made it easier for patients to track the progress of their referral, and pharmacies are being used to help people with suspected cancer. However, more needs to be done to address the underlying issues, including poor communication and delays. The DHSC spokesperson acknowledges that it will take time to turn around the NHS, but notes that improvements are starting to be seen, with patient satisfaction with primary care rising from 60% in July 2024 to 75%. Ultimately, the goal should be to provide timely and effective care to all patients, regardless of their background or circumstances.
Conclusion
The "referrals black hole" is a significant issue that affects a large number of patients in England. The lack of communication and transparency, combined with delays and inefficiencies, can have serious consequences for patients’ physical and mental health. While progress is being made, more needs to be done to address the underlying issues and ensure that patients receive the care they need in a timely and efficient manner. By prioritizing patient-centered care and improving communication and transparency, the NHS can work towards providing better outcomes for all patients.