Recurring concern
Unclear and unreliable GP access and referral pathways
Pin
Get email alerts
Request correctionFirst reported 8 Aug 2013•Latest report 20 Apr 2026
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.
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.
- Reports
- 17
- Individual concerns
- 19
- Date range
- 2013–2026
- Stated actions
- 28
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.
-
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.
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
-
Action
Educate triaging Consultants to use e-RS accurately for referral categorisation.
Stated by University Hospitals Sussex NHS Foundation Trust -
Action
Audit referral categorisation against triaging Consultants’ clinical narratives.
Stated by University Hospitals Sussex NHS Foundation Trust
-
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.
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.6
-
Action
Implement and disseminate an EMIS and laminated referral protocol covering paediatric pathways, hospital selection, advance contact, documentation and clinically appropriate ambulance transfer.
Stated by Old Mill Surgery -
Action
Issue a joint statement calling for improved primary-care access to specialist advice and expanded same-day emergency care options.
Stated by Royal College of General Practitioners -
Action
Communicate referral-route risks and Prevention of Future Deaths learning to members through a generic educational webinar.
Stated by Royal College of General Practitioners
-
Action
Review the Directory of Services with system partners to improve awareness of local adult and paediatric services.
Stated by George Eliot Hospital NHS Trust -
Action
Evaluate an electronic interface with the Directory of Services for General Practice.
Stated by George Eliot Hospital NHS Trust -
Action
Develop and disseminate coordinated communications describing GEH and SWFT services to referral partners and the public.
Stated by George Eliot Hospital NHS Trust
-
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.
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.5
-
Action
Issue a Practice Note clarifying that primary care mental health practitioners can directly refer patients to HBTT across all Trust boroughs.
Stated by Greater Manchester Mental Health NHS Foundation Trust -
Action
Include direct HBTT referral guidance in the Trust Patient Safety Newsletter distributed electronically to all staff.
Stated by Greater Manchester Mental Health NHS Foundation Trust -
Action
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.
Stated by Greater Manchester Mental Health NHS Foundation Trust
-
Action
Finalise the Referral and Assessment hub SOP by the end of May 2026.
Stated by Greater Manchester Mental Health NHS Foundation Trust -
Action
Establish a functioning Referral and Assessment hub in every Trust area by the end of August 2026 to provide a single external referral point.
Stated by Greater Manchester Mental Health NHS Foundation Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
Position
Mental health practitioners in general practice can directly refer to HBTT across all Trust boroughs after assessing the person’s mental health.
Stated by Greater Manchester Mental Health NHS Foundation Trust
-
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.
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.
-
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.
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
-
Action
Update the suspected heart failure pathway to clarify urgent referral routes and align them with two-week and two-to-six-week clinic provision.
Stated by North Central London ICB -
Action
Promote the updated suspected heart failure assessment and diagnosis pathway through primary care bulletins, the website and a GP webinar.
Stated by North Central London ICB
-
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.
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
-
Action
Use the Medical Leadership Forum to reiterate the urgent referral process and address concerns.
Stated by Herefordshire and Worcestershire Health and Care NHS Trust and NHS Herefordshire and Worcestershire Integrated Care Board -
Action
Disseminate information to GPs about urgent psychiatric review routes through direct communications, Teamnet and primary care network meetings.
Stated by Herefordshire and Worcestershire Health and Care NHS Trust and NHS Herefordshire and Worcestershire Integrated Care Board
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
-
Position
The established urgent-access process, including Single Point of Access, Home Treatment, Crisis Team and out-of-hours arrangements, is considered sufficient.
Stated by Herefordshire and Worcestershire Health and Care NHS Trust and NHS Herefordshire and Worcestershire Integrated Care Board
-
Position
Home Treatment or Crisis clinicians, rather than GPs, determine and arrange urgent psychiatric medical review following assessment.
Stated by Herefordshire and Worcestershire Health and Care NHS Trust and NHS Herefordshire and Worcestershire Integrated Care Board
-
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.
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.
-
Concerns raised1
Lack of specific instructions for GP practices making referrals to the Urgent Care and Assessment team
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.
-
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.
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.
-
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.
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
-
Action
Implement a duty-doctor and telephone-triage system providing prompt callbacks and same-day clinical assessment when routine appointments are unsuitable.
Stated by Peel Medical Practice
Data last updated 7 September 2026