Quarter of hospital referrals are sent straight back to GPs, survey finds

Around a quarter of patient referrals to hospitals are being rejected and returned to GPs, a poll has found.

More than a third of the so-called bouncebacks that doctors received asked them to do work considered outside their remit. Some GPs are now raising concerns that this is creating delays for suspected cancer patients.

In the survey of 712 GPs by healthcare magazine Pulse, doctors estimated that 26 per cent of referrals were returned under the category of advice and guidance (A&G) – even though this was not requested. 

A&G is designed for GPs to seek specialist advice before making referrals, but these unsolicited returns mean that those patients who doctors had intended to refer to hospital had to return to their GP for specialist advice. 

One London GP said they felt the system was ‘getting more risky and unsafe’ and contributed to their decision to leave general practice.

Family doctors also estimated that 36 per cent of the A&G they received required them to go outside of their normal remit. 

One in the North East also warned that A&G was creating ‘increasing barriers to two-week wait gastrointestinal referrals’ for patients with red-flag suspected cancer symptoms.

Dr Clare Bannon, GPs committee chairman 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 spokesman said: ‘Under this government, the A&G model has supported millions of patients to receive care in the right place without having to join elective waiting lists.

‘This is helping more patients to receive timely and appropriate care in primary and community settings.’