Recurring concern
Unclear and unreliable GP access and referral pathways
- Reports that mention this concern
- 17
- Times this concern has been raised
- 19
- Stated actions linked to this concern
- 28
What this concern includes
Includes failures of GP access and referral arrangements, including unclear access policies, inadequate instructions for making referrals, and other dedicated controls that leave patients or practices unable to identify or use the appropriate GP-related pathway.
What is not included
- Excludes failures in specialist or mental-health referral pathways where the GP access or referral process is not itself deficient.
- Excludes generic communication, training, staffing or governance deficiencies unless they directly impair GP access or referral arrangements.
- Excludes failures in clinical assessment or treatment after a patient has successfully accessed the appropriate GP or referral pathway.
- Excludes neutral descriptions of GP services or referral destinations without an identified unsafe access or pathway condition.
Trends
Reports over time
Reports mentioning this concern, 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.
Reports and published responses 17 reports
See individual reports that have raised this concern, and the actions taken in response
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Concerns raised1
Failure to translate GP-expressed urgency into accurate urgent booking codes
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- University Hospitals Sussex NHS Foundation Trust
Stated actions 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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University Hospitals Sussex NHS Foundation Trust
Educate triaging Consultants to use e-RS accurately for referral categorisation.
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University Hospitals Sussex NHS Foundation Trust
Audit referral categorisation against triaging Consultants’ clinical narratives.
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Concerns raised1
Lack of GP awareness of referral-route implications for local hospital triage and assessment
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked responses
- George Eliot Hospital NHS Trust
- Old Mill Surgery
- Royal College of General Practitioners
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.6
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Old Mill Surgery
Implement and disseminate an EMIS and laminated referral protocol covering paediatric pathways, hospital selection, advance contact, documentation and clinically appropriate ambulance transfer.
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Royal College of General Practitioners
Issue a joint statement calling for improved primary-care access to specialist advice and expanded same-day emergency care options.
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Royal College of General Practitioners
Communicate referral-route risks and Prevention of Future Deaths learning to members through a generic educational webinar.
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George Eliot Hospital NHS Trust
Review the Directory of Services with system partners to improve awareness of local adult and paediatric services.
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George Eliot Hospital NHS Trust
Evaluate an electronic interface with the Directory of Services for General Practice.
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George Eliot Hospital NHS Trust
Develop and disseminate coordinated communications describing GEH and SWFT services to referral partners and the public.
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Concerns raised1
Failure to allow direct referral from general practice to the HBTT for urgent high-risk referrals
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Linked response
- Greater Manchester Mental Health NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
-
Greater Manchester Mental Health NHS Foundation Trust
Issue a Practice Note clarifying that primary care mental health practitioners can directly refer patients to HBTT across all Trust boroughs.
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Greater Manchester Mental Health NHS Foundation Trust
Include direct HBTT referral guidance in the Trust Patient Safety Newsletter distributed electronically to all staff.
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Greater Manchester Mental Health NHS Foundation Trust
Hold an urgent-care away day to review and confirm the HBTT SOP and reinforce referral pathways and operational expectations, including direct referrals by primary care networks.
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Greater Manchester Mental Health NHS Foundation Trust
Finalise the Referral and Assessment hub SOP by the end of May 2026.
-
Greater Manchester Mental Health NHS Foundation Trust
Establish a functioning Referral and Assessment hub in every Trust area by the end of August 2026 to provide a single external referral point.
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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Greater Manchester Mental Health NHS Foundation Trust
Mental health practitioners in general practice can directly refer to HBTT across all Trust boroughs after assessing the person’s mental health.
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Concerns raised1
Blocking of direct booking with a patient's own GP for face-to-face assessment
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring 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 overarching guidance directing GPs to the appropriate cardiology pathway for complex cases
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- North Central London ICB
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
-
North Central London ICB
Update the suspected heart failure pathway to clarify urgent referral routes and align them with two-week and two-to-six-week clinic provision.
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North Central London ICB
Promote the updated suspected heart failure assessment and diagnosis pathway through primary care bulletins, the website and a GP webinar.
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Concerns raised1
Lack of GP awareness of how to request urgent psychiatric reviews
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked responses
- Herefordshire and Worcestershire Health and Care NHS Trust
- NHS Herefordshire and Worcestershire Integrated Care Board
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
-
Herefordshire and Worcestershire Health and Care NHS Trust and NHS Herefordshire and Worcestershire Integrated Care Board
Use the Medical Leadership Forum to reiterate the urgent referral process and address concerns.
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Herefordshire and Worcestershire Health and Care NHS Trust and NHS Herefordshire and Worcestershire Integrated Care Board
Disseminate information to GPs about urgent psychiatric review routes through direct communications, Teamnet and primary care network meetings.
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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Herefordshire and Worcestershire Health and Care NHS Trust and NHS Herefordshire and Worcestershire Integrated Care Board
The established urgent-access process, including Single Point of Access, Home Treatment, Crisis Team and out-of-hours arrangements, is considered sufficient.
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Herefordshire and Worcestershire Health and Care NHS Trust and NHS Herefordshire and Worcestershire Integrated Care Board
Home Treatment or Crisis clinicians, rather than GPs, determine and arrange urgent psychiatric medical review following assessment.
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Concerns raised1
Failure of GP registration processes to enable registration without relevant documentary proof
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised1
Lack of specific instructions for GP practices making referrals to the Urgent Care and Assessment team
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Delays and unavailability in access to GP appointments
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring 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
Delays in access to a GP for medication discussions
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Linked response
- Peel Medical Practice
Stated actions 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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Peel Medical Practice
Implement a duty-doctor and telephone-triage system providing prompt callbacks and same-day clinical assessment when routine appointments are unsuitable.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Data last updated 7 September 2026