New GP crisis as struggling hospital trusts reject specialist referrals for hundreds of thousands of patients

Hundreds of thousands of patients referred to specialists by their GPs are being rejected by hospitals and left to deteriorate because there are no appointments available.

NHS waiting lists are already buckling under record-high backlogs and now delays are being compounded as local doctors struggle to even get their patients to outpatient services.

Patients’ referrals are rejected by hospital trusts if there are no appointment slots available, meaning they get bounced back to the GP who is unable to help with their complex needs, leaving them without the care they desperately need.

Clare Rayner, 54, from Manchester, has been left distraught by delays which have hampered the treatment she needs for complex spinal problems. She is still waiting to find out if an upcoming appointment with a neurologist is going ahead after a request for an urgent review from her GP was ignored five times.

Outpatient referrals are typically classed as having an “appointment slot issue” (ASI) when no booking slot is available within a specific time frame, under the NHS e-Referral system.

According to experts, the situation varies between specialities, but is reportedly particularly bad in areas such as mental health and neurology.

Ms Rayner, a former medical teacher who had to retire because of ill health, said: “I’ve been sent all around the country for neurosurgery over the last few years so have been directly affected by being bounced back to my GP."

“A unit in London rejected me because they said I lived too far away, which was ridiculous as they take people from all over the UK, and a local consultant just never replied to my GP’s email.

Ms Rayner said she has endured “massive delays” to her care which had left her intensely frustrated. “It’s left me with significant deterioration with my spinal problems and that’s been very distressing,” she said.

Helen Hughes, chief executive of charity and campaign group Patient Safety Learning, said: “NHS England needs to urgently investigate, quantify the scale of the problem and take action if we are to prevent these capacity problems resulting in avoidable harm for patients.”

A target for providers to reduce ASIs to a rate of 4% or less of their total outpatient activity was set by NHS England in 2019. Guidance in subsequent years has seen a move towards the requirement for providers to implement “innovative pathways” to support prevention of ill health.

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Source: iNews, 22 May 2022

Related blogs on the hub:

• Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs
• A child left waiting for ‘urgent’ surgery, a blog by Clare Rayner