One in seven patients stuck in a GP referrals ‘black hole’
New research by Healthwatch England revealed that one in seven patients (14%) have been stuck between their GP and hospital teams, often due to a delay in the referral being sent, or the referral being lost, rejected, or never sent.
Seven in ten of this group (71%) only found out that they hadn’t joined a waiting list for specialist care after chasing NHS teams up themselves.
The poll of 2,622 adults in England referred by their GP for specialist tests or treatment in the last year suggests that quicker referral confirmations, clearer communication, and greater patient choice significantly improve people’s satisfaction with the referral process.
People’s satisfaction with GP referrals
- Almost one in four (23%) were dissatisfied with the referral process.
- 62% of people were satisfied with the process:
- Satisfaction rose to 67% when people were referred between their first and third GP appointment.
- Satisfaction rose to 88% when hospital teams accepted referrals in a week or less.
- Satisfaction rose to 83% when people were given all the information they need along with a referral.
- Satisfaction rose to 77% when people were given a choice of hospital location, consultant, or appointment time.
- Satisfaction rose to 98% when people had all four of the above.
The poll also found that 14% of people bounced back to their GP following a delayed or failed referral.
Three quarters (75%) of this group reported at least one negative impact on their health and wellbeing, compared to just over one in three (36%) who experienced no referral issues.
Seven in ten (70%) delays and just under one in ten (8%) rejections were only uncovered after patients chased updates, which suggests the total figure of people who experienced issues could be higher.
Are improvements to GP referrals working?
Since 2023, the Government and the NHS have taken steps to improve the referral process, including:
- Using the NHS App to give patients greater visibility of their referral
- Piloting the use of pharmacies to refer people with suspected cancer
- Enabling GPs to get expert advice before making a formal referral to help direct patients to the right care they need more quickly.
We commissioned the research to assess whether recent changes to the referral process had made a difference following reports of poor patient experience in 2023.
It concluded that some improvements were made, including how quickly people are referred by GPs.
Overall, fewer people fell into the referrals ‘black hole’ (14%) compared to the last time the patient champion ran similar research (21%) in 2023.
Yet despite progress, many patients still report that poor communication, delays, and uncertainty caused by long waits are affecting their health, wellbeing, and ability to work.
The NHS must close GP referrals 'black hole'
As the NHS shifts to delivering more care closer to people’s homes, healthcare leaders must act now to close referral black holes to improve patient safety, experiences, and outcomes.
Chris McCann, Deputy Chief Executive at Healthwatch England, said: “GP referrals are the gateway to specialist care and that’s why healthcare leaders need to take action to ensure they work for everyone.
“Behind every delayed, lost, or rejected referral is a human story of pain, stress, and uncertainty. And while improvements have been made, too many people remain stuck in the referral ‘black hole’, telling us they’re ‘existing, not living’ due to delays.
“Simple steps, such as quicker GP referrals, faster hospital confirmations, and better communication, would ensure people don’t bounce back to busy GP teams and improve their safety and experience.
“We call for a referrals checklist with clear responsibilities across NHS teams, accurate waiting time estimates, and rapid implementation of Jess’ Rule to ensure patients are referred when health issues remain unresolved.”
Patrick’s story: I feel like I’m stuck in limbo
Retired NHS worker Patrick, 70, from Milton Keynes, has been waiting to be seen by a specialist for his back and hip pains since July. After being referred by his GP, Patrick never received any communications about when he will be seen. He had to call the hospital department himself to find out.
“When I rang, they were nice on the phone, but they couldn’t give me any good news. It could be as long as a year before I get an appointment, and that’s just to take the first step in a long process.”
Patrick says the pain has become so bad that it’s making it hard for him to do everyday activities, such as shopping, driving or even putting on his shoes. And with no NHS updates or communications, he’s left not knowing where to turn while his condition gets worse.
“I feel like I’m stuck in limbo. The pain’s impacting how often I can get out and do everyday activities.”
Downloads
You can also read more about this report on the Healthwatch England website using this link or paste this into your browser address bar and press enter https://www.healthwatch.co.uk/report/2025-12-08/referrals-improving-experiences-and-closing-black-holes#Download
or download the full Healthwatch England report below
