Recurring concern
Unreliable mental health referral pathways
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Request correctionFirst reported 4 Sep 2013•Latest report 25 Jun 2026
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
- Individual concerns
- 136
- Date range
- 2013–2026
- Stated actions
- 173
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
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.
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.
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Concerns raised2
Delays in progressing referrals
Failure to make additional enquiries to locate missing referral information
Responses linked to these concernsEach 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
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Action
Change the CAMHS operating procedure to offer appointments when referral contact numbers are missing.
Stated by Betsi Cadwaladr University LHB -
Action
Audit CAMHS practice to confirm the revised referral procedure is embedded.
Stated by Betsi Cadwaladr University LHB
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Concerns raised1
Failure to refer or transfer care to the geographically appropriate community mental health team
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach 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
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Action
Redirect rural patients to Winchester-based community mental health staff through new locality working arrangements.
Stated by Hampshire and Isle of Wight Healthcare NHS Foundation Trust
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Concerns raised2
Failure to explain the rationale, provision and NHS alternatives for a private psychotherapy referral
Failure to provide an effective alternative when a referred provider does not respond
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Failure of crisis text services to use Greater Manchester mental health pathways for early referral
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach 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
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Action
Implement a phased, locally delivered crisis-text service integrated with the Greater Manchester 111 mental-health crisis line.
Stated by NHS Greater Manchester Integrated Care Board
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
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Position
The non-NHS charity’s service delivery and clinical governance arrangements fall outside the respondent’s ability to comment on.
Stated by NHS England
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Position
Independent charitable organisations providing crisis text services are outside Government and NHS control.
Stated by Department of Health and Social Care
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Concerns raised1
Reliance on unrealistic self-referral for people requiring mental health and substance misuse support
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 concernsEach 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.3
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Action
Establish a dedicated electronic-system referral pathway for dual-diagnosis support before patient discharge.
Stated by Nottinghamshire Healthcare NHS Foundation Trust -
Action
Update internal working instructions on staff expectations for supporting people who need self-referral to other services.
Stated by Nottinghamshire Healthcare NHS Foundation Trust -
Action
Share and discuss self-referral learning at a planned learning event to support awareness and practice change.
Stated by Nottinghamshire Healthcare NHS Foundation Trust
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Concerns raised1
Failure to account for mental health crisis team inability to enter locked premises when directing callers to mental health services
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach 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.3
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Action
Monitor and work with partners on powers of entry so agencies understand legal parameters and available options.
Stated by College of Policing -
Action
Collate concerns raised, review them against the toolkit and guidance, and amend the toolkit where necessary.
Stated by College of Policing -
Action
Continue reviewing toolkit content and provide forces with tools, training and support to implement and deliver Right Care, Right Person.
Stated by College of Policing
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
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Position
A review found no significant failings in the use or implementation of the Right Care Right Person policy.
Stated by Police and Crime Commissioner for Durham
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Position
Operational decisions and responses under Right Care, Right Person are the responsibility of individual police forces, including Durham Constabulary.
Stated by College of Policing -
Position
Police cannot enter a person’s home for a welfare check where assessed risk does not reach the threshold of risk to life and limb.
Stated by College of Policing
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Concerns raised1
Failure of some mental healthcare trusts to accept referrals for homeless prisoners on release
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 concernsEach 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.3
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Action
Provide RECONNECT care-after-custody support and release planning to improve continuity of care for people leaving prison.
Stated by NHS England -
Action
Review and refresh the prison mental health service specification, using case learning to strengthen continuity and transfer of care.
Stated by NHS England -
Action
Consider developing national pathway guidance with adult mental health services for people leaving prison.
Stated by NHS England
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
There are currently no plans to develop specific national pathway guidance for people leaving prison, although this may be considered longer-term.
Stated by NHS England
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Concerns raised1
Delays in reattempting crisis-house placement after a disputed refusal
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 concernsEach 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
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Action
Require senior clinical review, an alternative plan, documented accountability and formal escalation before finalising any declined crisis house referral.
Stated by North London NHS Foundation Trust -
Action
Provide clinicians with 24/7 Crisis Hub access to senior clinical advice for urgent escalation and referral guidance.
Stated by North London NHS Foundation Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
The referring team is responsible for reviewing declined referrals and agreeing an alternative plan.
Stated by North London NHS Foundation Trust
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Concerns raised1
Failure to identify the person declining a referral
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 concernsEach 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
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Action
Extend web-based call handling and recording systems to UCAT services and train staff to use them.
Stated by Northamptonshire Healthcare NHS Foundation Trust
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Concerns raised1
Failure to automatically refer suspects interviewed voluntarily for relevant offences to mental health services
Responses linked to these concernsEach 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
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Action
Revise procedures so voluntary and arrested suspects receive consistent welfare assessments and automatic Liaison and Diversion referrals.
Stated by Nottinghamshire Police -
Action
Communicate the amended safeguarding policy across the organisation by 1 March 2025.
Stated by Nottinghamshire Police
Data last updated 7 September 2026