Number unable to get a hospital appointment after GP referral up 50 per cent in two years

The number of patients unable to get a hospital appointment after being referred by their GP is up more than 50 per cent in two years amid the record NHS backlog, official data show.

NHS Digital figures show no appointments were immediately available for 2.3 million referrals made in the first six months of this year – up 51 per cent on the same period in 2020.

Every month, on average, almost 400,000 referrals were recorded as having an “appointment slot issue” between January and June this year, compared to 220,000 in the same period in 2020.

Appointment slot issues occur when a patient is referred by their GP through the NHS e-Referral Service but no appointment is available to book.

The referral is then forwarded or deferred to a patient’s chosen provider, but if an appointment is not made within 180 days it will automatically be removed from the system, according to NHS Digital.

Patient safety campaigners have said the scale of the problem must be “urgently investigated” by NHS England to ensure the safety of patients is not being compromised while they wait for appointments.

GPs have claimed patients with complex needs are being pushed back into primary care because of a lack of capacity in hospitals.

The NHS Digital website says: “Appointment slot issues compound waits by creating a backlog of patients whose waiting time has already started, creates a significant amount of avoidable administrative work and can cause patient safety issues.”

Appointment slot issues can risk patients being “missed” from trusts’ lists or have an incorrect start time recorded for their referral to treatment wait time.

Earlier this year, the Royal College of GPs warned that there was a risk of patients “simply disappearing” off lists if the problem was not dealt with, the Health Service Journal reported.

But NHS England stressed that patients are not removed from the official waiting list when they are categorised as an appointment slot issues or after the 180-day cut off.

Dr Gary Howsam, the Royal College of GPs vice chairman, told The Telegraph: “GPs work very hard to refer patients appropriately, and timely treatment can make all the difference – so it is unacceptable if patients find themselves back to square one because of delays that are no fault of their own.

“Backlogs also place additional pressures on general practice at a time when our service is already stretched beyond endurance.”

It comes as a record 6.6 million patients are waiting to start treatment after being referred. Official data, analysed by the Labour Party, show that 354,001 patient referrals made in June were deferred because no appointment was available – up 45 per cent on June 2020 (243,549).

Of those, 34,418 were for children and young people, while 53,729 were for suspected cancer, which should be seen within two weeks of a GP referral.

Appointments may not be available because of technical problems preventing them being booked, or because the chosen provider has not made sufficient slots available, according to the NHS Digital website.

Wes Streeting, the Labour shadow health secretary, said: “Not only is the Conservatives’ backlog forcing people to wait in pain, it’s also putting them at risk.

“Patients deserve a government that gets them the care they need quickly and takes safety seriously. But whoever wins the Conservative leadership race will have been complicit in the neglect of our NHS.”

Helen Hughes, the chief executive of the Patient Safety Learning charity, said: “We have significant concerns about the safety of patients who are facing increasingly long waits for treatment, particularly those on high priority cancer pathways and urgent referrals.”

She said patients needed to be assured that they will “not be lost in a failing, complex system”, adding: “We believe that NHS England needs to urgently investigate, quantify the scale of the problem and take action if we are to prevent these capacity and system issues resulting in avoidable harm for patients.”

Some GPs told Patient Safety Learning they had experienced difficulties getting referrals accepted. One GP, based in the North East, said: “There is an ever-creeping transfer of management of complex conditions from secondary to primary care, without adequate training or resources to manage this safely.”

An NHS spokesman said: “The NHS delivers tens of millions of outpatient appointments every year, while the latest figures show that there was a record number of diagnostic checks and tests in May.

The spokesman said health service staff were “pulling out all the stops to cut waiting times for patients across all areas as more people come forward for care”.