A new poll has found that around a quarter of patient referrals are being rejected and returned to GPs, sparking concern over delays for patients with suspected cancer. The research, conducted by Pulse, found that more than a third of these bouncebacks asked GPs to carry out work outside of their remit, while other medics raised concerns that the process is creating delays for people with possible cancer symptoms.
Survey findings and GP concerns
In the survey of 712 GPs, doctors estimated that 26 per cent of attempted referrals were returned as advice and guidance (A&G) when it was not requested. A&G is designed for GPs to seek specialist advice before making referrals. However, these unsolicited returns mean patients doctors had intended to refer to hospital had to return to their GP for specialist advice.
Family doctors also estimated that 36 per cent of the A&G they received required them to go outside of their normal remit. One London GP told Pulse they feel the system is “getting more risky and unsafe”, and contributed to their decision to leave general practice. A GP in the North East warned that the delays were creating “increasing barriers to two-week-wait gastrointestinal referrals” for patients with red-flag suspected cancer symptoms.
Official responses
Dr Clare Bannon, GPs committee chairwoman at the British Medical Association, told Pulse: “Where a referral is requested hospital trusts are contractually obliged to accept referrals from general practice, except in very limited circumstances. Referrals should not simply be rejected with requests for additional GP actions unless part of a locally-agreed pathway.”
A Department of Health and Social Care spokesperson said: “Under this Government, the advice and guidance model has supported millions of patients to receive care in the right place without having to join elective waiting lists, alongside the 2,000 extra GPs we have recruited since July 2024. This is helping more patients to receive timely and appropriate care in primary and community settings, and that is one of the reasons 77 per cent of patients are now reporting a ‘good’ overall experience with their GP.”
An NHS spokesperson said: “While Pulse acknowledges that this survey – which offered a £500 prize – is not scientifically representative of GPs, the simple truth is that advice and guidance is a well-established and successful way of giving patients earlier input from an expert consultant, while still allowing them to be seen in hospital if needed.”
