Recurring concern
Unreliable mental health referral pathways
First 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 raised1
Failure to facilitate general practitioners’ referrals for formal mental health assessment and treatment
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 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 the CAMHS GP referral form process to capture sufficient information for timely assessment
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.4
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Action
Maintain updated referral guidance for use with CAMHS referrals.
Stated by Sheffield Children'S NHS Foundation Trust -
Action
Review and amend the CAMHS referral form using General Practitioner and service-user feedback.
Stated by Sheffield Children'S NHS Foundation Trust -
Action
Update referral guidance to support the revised CAMHS referral form.
Stated by Sheffield Children'S NHS Foundation Trust
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Action
Distribute the revised CAMHS referral form and supporting guidance to all General Practitioners by 12 July 2019.
Stated by Sheffield Children'S NHS Foundation Trust
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Concerns raised1
Failure to maintain a system clearly identifying GP and geographical boundaries for local mental health services
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.
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 to ensure CAMHS referral pathways remain operable where school psychology services are unavailable
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 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
Review the CAMHS referral pathway for GPs and schools.
Stated by NHS West Yorkshire Integrated Care Board -
Action
Establish Mental Health Support Teams in and near schools and colleges through 25 trailblazer sites to provide earlier support for children and young people.
Stated by Department of Health and Social Care -
Action
Provide 24/7 crisis care access for children, young people and their families through NHS111 by 2023/24.
Stated by Department of Health and Social Care
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
Local NHS services and local authorities are responsible for responding to the concerns and learning from deaths to improve service safety.
Stated by Department of Health and Social Care
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Concerns raised1
Lack of a policy for referral to mental health services following prolonged social isolation
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.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Incorrect understanding of referral routes to the Approved Mental Health Practitioner Service
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.1
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Action
Improve staff and manager fluency in routes and response expectations for general mental health and Mental Health Act assessments.
Stated by East London NHS Foundation Trust and London Borough of Hackney
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Concerns raised1
Lack of safeguards to ensure MASH referrals are followed up by the appropriate Community Mental Health Team
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 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
Implement a standardised log across community mental health teams for recording received SCARF forms and resulting actions.
Stated by Surrey and Borders Partnership NHS Foundation Trust -
Action
Establish a high-risk SCARF checking process requiring MASH practitioners to telephone relevant community mental health teams about receipt and urgent action.
Stated by Surrey and Borders Partnership NHS Foundation Trust
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 phone call for every SCARF form was not considered workable because of the volume of forms received and processed.
Stated by Surrey and Borders Partnership NHS Foundation Trust
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Position
Ensuring partner agencies act on MASH referrals falls outside the existing Surrey Police and Surrey County Council agreement.
Stated by Surrey Police -
Position
SABP and Adult Social Care are responsible for responding on whether Community Mental Health Teams follow up MASH referrals.
Stated by Surrey Police
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Concerns raised1
Failure of mental health referral routing between teams
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
Process every NELFT referral and redirect misrouted referrals to the correct team within two working days.
Stated by North East London NHS Foundation Trust
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Concerns raised1
Failure to clearly communicate when psychiatric assessment is believed necessary in referrals
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.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Lack of a national framework governing private providers’ response times to referrals for locked rehabilitation units
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
Require NHS England-commissioned specialist mental health providers, public and private, to respond to referrals within specified timeframes through standardised contracts.
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
For specialist rehabilitation services commissioned by Clinical Commissioning Groups, referral response-time requirements are determined locally by the relevant commissioning CCG.
Stated by NHS England
Data last updated 7 September 2026