First reported 4 Sep 2013•Latest report 25 Jun 2026
Definition
What this concern includes
Includes failures of mental health referral pathways, including identifying when referral is indicated, selecting the correct route, accepting direct referrals, making or re-making referrals, receiving and actioning referrals, and providing clear urgency or follow-up arrangements.
Not included
Excludes failures limited to assessment or treatment after a mental health referral has been successfully received and actioned.
Excludes generic social-care, occupational-health or other specialist referrals unless the report explicitly concerns the mental health referral pathway.
Excludes generic communication, training or documentation deficiencies that are not directly tied to making, receiving, processing or following up a mental health referral.
Excludes urgent mental-health referral and assessment delays where the existing dedicated urgent mental-health pathway concern is the more specific supported boundary.
Reports
110
Distinct published reports
Individual concerns
136
A report can raise multiple concerns
Date range
2013–2026
First to latest report issue date
Stated actions
173
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Department of Health and Social Care19
NHS England15
HM Prison and Probation Service6
NHS Greater Manchester Integrated Care Board6
North East London NHS Foundation Trust5
Greater Manchester Mental Health NHS Foundation Trust4
Pennine Care NHS Foundation Trust4
Surrey and Borders Partnership NHS Foundation Trust4
College of Policing3
Department for Education3
Essex Partnership University NHS Foundation Trust3
Ministry of Justice3
Norfolk and Suffolk NHS Foundation Trust3
North London NHS Foundation Trust3
Nottinghamshire Healthcare NHS Foundation Trust3
NHS trust66
Ministerial department24
Executive non-departmental public body16
Healthcare site15
Integrated care board15
Police force10
Executive agency6
English county council5
Private limited company5
Local health board4
Multi-service care provider4
English unitary authority3
London borough council3
National policing body3
Prison or young offender institution3
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
East London
Concerns raised1
Failure to refer residents for mental health assessment when indicated by mental illness, self-harm history or deteriorating mental state
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Action
Deliver targeted provider training on safeguarding, escalation processes and risk identification, including notifying the Local Authority and making safeguarding referrals for identified self-harm or other health risks.
Stated by The Local AuthorityStated plannedThe respondent said that this action was planned when they made their response on 3 April 2024.
Action
Inform care staff that local mental health teams accept referrals from patients, carers and other medical professionals.
Stated by The Evergreen Surgery, WansteadStated completedThe respondent said that this action was complete when they made their response on 3 April 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
A mental-health referral required the consent of a patient assessed as having capacity, and depended on his willingness to consent.
Stated by The Evergreen Surgery, WansteadUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Inner South London
Concerns raised1
Lack of contact details for neighbouring psychiatric liaison and crisis mental health teams
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Existing NHS Service Finder and website directories provide professionals with current neighbouring mental health service contact details and referral information.
Stated by NHS EnglandExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Cornwall and Isles of Scilly
Concerns raised1
Failure to provide sufficient staffing for community mental health team referral screening
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Grow the mental health workforce by an additional 27,000 staff to increase service capacity.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 12 February 2024.
Birmingham and Solihull
Concerns raised3
Lack of GP awareness that referrals to secondary services may not be considered by secondary services
Failure to inform referring GPs when referrals to secondary services are rejected
Failure of secondary services to consider referrals requesting their review and assessment
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
Action
Amend the GP referral form to clarify that the service will assess referrals and determine where patients’ needs are best met, removing confusing secondary-care terminology.
Stated by Birmingham and Solihull Mental Health NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 13 November 2023.
Action
Continue disseminating the referral and service-model information through GP communications, engagement sessions, meetings and healthcare partnership forums.
Stated by Birmingham and Solihull Mental Health NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 13 November 2023.
Action
Establish effective working relationships and clarify referral processes between mental health services and general practice.
Stated by NHS Birmingham and Solihull Integrated Care BoardStated plannedThe respondent said that this action was planned when they made their response on 13 November 2023.
Action
Operate a central general-practice portal for consolidating referral protocols.
Stated by NHS Birmingham and Solihull Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 13 November 2023.
Action
Include mental-health referral protocols in the central general-practice portal.
Stated by NHS Birmingham and Solihull Integrated Care BoardStated plannedThe respondent said that this action was planned when they made their response on 13 November 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
The referral showed no need for medical input or urgent intervention and was handled within the suggested timeframe.
Stated by Birmingham and Solihull Mental Health NHS Foundation TrustDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
Established local triage of Community Mental Health and Wellbeing Service referrals is considered sufficient.
Stated by Birmingham and Solihull Mental Health NHS Foundation TrustExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
Specialist mental health services, including PCN mental health professionals, should assess need and determine appropriate service placement rather than individual GPs.
Stated by Birmingham and Solihull Mental Health NHS Foundation TrustRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Inner North London
Concerns raised1
Failure to refer patients to the crisis team during delays in community mental health follow-up
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Clinical assessment found low self-harm risk, so discharge with routine CMHT referral rather than crisis services was considered appropriate.
Stated by South West London and St George'S Mental Health NHS TrustDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
South Yorkshire (Western)
Concerns raised1
Failure to refer students to NHS mental health services when they are receiving other support
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Establish an I-Space discharge process providing the academy with reports on continuing support and potential re-referral.
Stated by Outwood Grange Academies TrustStated completedThe respondent said that this action was complete when they made their response on 30 October 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Decisions about appropriate school support services are delegated to school leaders rather than prescribed by the Department.
Stated by Department for EducationRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
East London
Concerns raised1
Failure to make formal mental health referrals for reluctance to accept offered care
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Dorset
Concerns raised3
Breakdown in communication about the steps and responsibilities for Mental Health referral
Failure to send a letter confirming the respective responsibilities of the doctor and patient
Absence of an automatic Mental Health referral pathway after 90 days of sobriety
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Action
Obtained current CMHT referral pathways, Pan Dorset guidance and integrated community mental-health procedures.
Stated by the Partners in the PracticeStated completedThe respondent said that this action was complete when they made their response on 4 August 2023.
Action
Met system patient-safety and mental-health representatives to discuss referral matters and criteria.
Stated by the Partners in the PracticeStated completedThe respondent said that this action was complete when they made their response on 4 August 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.4
Position
The Practice disputes that communication broke down or that it miscommunicated the steps required for a mental health referral.
Stated by the Partners in the PracticeDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
The Practice considers the hepatologist’s written communication to the patient sufficient and will not routinely send reminder letters about requesting referrals.
Stated by the Partners in the PracticeExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
The Practice considers automatic referral after abstinence inappropriate and unworkable because relapse or changed mental health needs require review before referral.
Stated by the Partners in the PracticeNo action considered necessaryThe respondent said that no further action was needed.
Position
The Practice disputes that 90 days’ sobriety was a formal mental health referral rule, describing it as a historic misunderstanding.
Stated by the Partners in the PracticeDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Derby and Derbyshire
Concerns raised1
Lack of understanding by Trust mental health practitioners of appropriate referral services for Veterans
This report raised 10 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
Action
Distribute veteran-service leaflets, posters and QR-linked intranet information to mental-health practitioners and Trust services.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 12 June 2023.
Action
Scope mandatory veteran-status recording, service hyperlinks and referral-support prompts in RiO.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 12 June 2023.
Action
Include self-referral support and veteran referral requirements in the updated LMHT Standard Operating Procedure and distribute it to staff.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 12 June 2023.
Action
Share the Veteran folder across Mental Health Services after suitability review.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 12 June 2023.
North Northumberland and South Northumberland
Concerns raised1
Delays and failures in referral to the Community Treatment Team
This report raised 12 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
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Includes failures of mental health referral pathways, including identifying when referral is indicated, selecting the correct route, accepting direct referrals, making or re-making referrals, receiving and actioning referrals, and providing clear urgency or follow-up arrangements.
