What to expect from the NHS referral system

Katie

·January 22, 2025

·11 min read

What to expect from the NHS referral system — Image Source: unsplash

The NHS referral system helps you access the right healthcare services. It ensures you receive care tailored to your needs by connecting you with specialists or services. Your journey begins with a consultation with your GP, who assesses your condition and decides if a referral is necessary. This process ensures you get the most appropriate treatment or advice. By understanding how the system works, you can feel more confident and prepared when navigating your healthcare options.

Key Takeaways

The NHS referral system helps you see specialists if your GP cannot help.
Learn about referral types: routine, urgent, two-week wait, and self-referrals, to manage your healthcare better.
Write down your symptoms and questions before seeing your GP. This helps them decide if you need a referral.
After a referral, check for updates and contact your GP or specialist if there are delays.
Know your NHS rights, like picking your GP and hospital, to stay in charge of your healthcare.

What is the NHS referral system?

Definition and purpose

The NHS referral system connects you to the right healthcare services when your GP believes you need specialist care. It acts as a bridge between primary care (your GP) and secondary or specialised care, such as hospital consultants or therapists. This system ensures you receive the most appropriate treatment for your condition. By guiding you to the right specialist, it helps improve the quality of care and ensures resources are used effectively.

Why referrals are needed

Referrals are necessary when your GP cannot provide the care or expertise required for your condition. For example, if you have persistent symptoms that need further investigation, your GP may refer you to a specialist. Referrals also help ensure you access advanced diagnostic tests, treatments, or therapies that are not available in general practice. This process ensures your healthcare journey is tailored to your specific needs.

Types of referrals in the NHS

The NHS referral system includes several types of referrals, depending on your condition and the care you need. Common types include:

Routine referrals: These are for non-urgent conditions where you need to see a specialist but can wait for an appointment.
Urgent referrals: These are for conditions that require quicker attention, such as suspected cancer or severe symptoms.
Two-week wait referrals: These are a specific type of urgent referral for suspected cancer cases, ensuring you see a specialist within two weeks.
Self-referrals: In some cases, you can refer yourself to certain services, such as physiotherapy or sexual health clinics, without seeing a GP first.

Understanding these types helps you know what to expect and how your care will be prioritised.

How does the NHS referral system work?

GP consultation and referral decision

Your journey through the NHS referral system begins with a consultation with your GP. During this appointment, your GP evaluates your symptoms and medical history to determine if specialist care is necessary. The decision-making process often follows these steps:

Complete a self-report form if your condition requires it, such as for neurodevelopmental concerns.
Share the completed form with your GP during the consultation.
Wait for your GP to assess your condition and decide on the referral.
Provide any additional information requested after your GP initiates the referral.

This structured approach ensures your GP gathers all the necessary details to make an informed decision about your care.

Referral submission process

Once your GP decides to refer you, they submit the referral to the appropriate specialist or service. This process involves sending your medical information and referral request through a secure system. You may receive a notification confirming the referral has been made. In some cases, you might need to provide additional details or complete forms to finalise the submission.

Your GP will explain the next steps, including how long you might wait to hear from the specialist. Staying proactive by following up with your GP or the referred service can help you stay informed about your referral status.

Booking and attending a specialist appointment

After the referral is submitted, you will need to book your specialist appointment. Many patients face challenges during this stage, such as unclear communication about appointment details or system errors in the booking process. Transport issues and inflexible scheduling can also make attending appointments difficult.

To avoid these problems, ensure you confirm the appointment details and plan your travel in advance. If you encounter any issues, contact the service provider or your GP for assistance. Attending your appointment on time is crucial for receiving the care you need.

How long does the NHS referral process take?

Typical waiting times for referrals

The time it takes to complete a referral in the NHS varies depending on the urgency of your condition. Routine referrals often take several weeks or even months. For urgent cases, such as suspected cancer, you can expect to see a specialist within two weeks. Emergency referrals, like those made through A&E, are handled immediately. These timelines ensure that patients with the most critical needs receive care first. However, waiting times may differ based on your location and the availability of specialists.

Factors influencing waiting times

Several factors can affect how long you wait for a referral. The availability of specialists in your area plays a significant role. Some regions face shortages of healthcare professionals, which can lead to longer delays. The type of referral also matters. Urgent referrals are prioritised, while routine ones may take longer. Seasonal demand, such as winter pressures on the NHS, can further extend waiting times.

The study indicates that waiting times for A&E and cancer referrals do not significantly affect public trust in the NHS. Instead, trust is influenced more by sociopolitical factors such as ethnicity, political affiliation, age, and local unemployment rates.

Understanding these factors can help you manage your expectations and plan accordingly.

What to do if there are delays

If you experience delays in your referral, take proactive steps to address the issue. Contact your GP to check the status of your referral. They can provide updates or escalate the matter if necessary. You can also reach out to the specialist service directly for information about your appointment. In some cases, you may have the option to choose a different hospital or clinic with shorter waiting times. Staying informed and persistent ensures you remain in control of your healthcare journey.

What do patients need to do during the referral process?

Preparing for GP appointments

Preparation is key when visiting your GP. Start by noting down your symptoms, including when they began and how they affect your daily life. If you have questions about your condition or treatment options, write them down beforehand. Bring a list of any medications you take, including over-the-counter drugs and supplements. This helps your GP understand your medical history better.

If your GP has asked you to complete a form or questionnaire, ensure you fill it out accurately and bring it with you. Arrive on time for your appointment to avoid delays. Being prepared allows your GP to make an informed decision about whether a referral is necessary.

Following up on referrals

After your GP submits the referral, you should stay proactive. Keep track of any notifications or letters you receive about your referral. If you do not hear back within the expected timeframe, contact your GP or the specialist service to check the status. Sometimes, delays occur due to administrative issues or high demand.

You can also ask your GP for a copy of the referral letter. This document contains important details about your case and can be useful if you need to follow up with the specialist directly. Staying organised ensures you remain informed throughout the process.

Attending specialist appointments

When attending your specialist appointment, preparation is just as important. Bring any documents or test results your GP has provided. Arrive early to allow time for registration or unexpected delays. During the appointment, describe your symptoms clearly and answer the specialist’s questions honestly.

If you do not understand something, ask for clarification. Specialists often provide advice or treatment plans, so take notes or ask for written instructions. After the appointment, follow the specialist’s recommendations and schedule any follow-up visits if required. Being engaged during this stage ensures you get the most out of your care.

Tip: Keep a folder with all your referral-related documents, including appointment letters and test results. This helps you stay organised and prepared.

What happens after a referral in the NHS?

Possible outcomes of a referral

After your referral, the specialist will assess your condition and decide on the next steps. The outcomes can vary depending on your diagnosis and treatment needs. You might receive a treatment plan, which could include medication, therapy, or further tests. In some cases, the specialist may refer you to another department for more specific care.

If your condition does not require specialist intervention, the specialist may discharge you back to your GP. This means your GP will continue managing your care. Sometimes, the specialist might recommend lifestyle changes or self-management strategies to help you improve your condition. Understanding these outcomes helps you prepare for what lies ahead.

Follow-up care and next steps

Follow-up care ensures you continue receiving the support you need after your initial appointment. If the specialist prescribes treatment, they may schedule follow-up visits to monitor your progress. These appointments allow them to adjust your treatment plan if necessary.

For conditions requiring long-term management, you might work with a multidisciplinary team. This team could include nurses, therapists, or other healthcare professionals. If you are discharged back to your GP, they will oversee your care and arrange any additional services you need. Staying engaged with your healthcare providers ensures you remain on track with your recovery or management plan.

Patient rights and choices

You have several rights when navigating the NHS referral system. These rights empower you to make informed decisions about your care:

You can choose your GP practice unless there are valid reasons for refusal.
You can request appointments with a specific GP at your practice.
You have the right to choose the hospital for your outpatient appointments.
For non-urgent conditions, you should start consultant-led treatment within 18 weeks of your referral.
You have the right to participate in decisions about your care and treatment.
You can refuse tests or treatments, provided you understand the consequences.

Knowing your rights helps you take an active role in your healthcare journey. If you feel your rights are not being respected, speak to your GP or the Patient Advice and Liaison Service (PALS) for support.

The NHS referral system ensures you receive care from the right specialists for your needs. By understanding how it works, you can reduce uncertainty and feel more in control of your healthcare journey. Many patients report feeling forgotten during the process, often due to poor communication. This can lead to stress and anxiety. Staying informed helps you avoid these challenges. You will know whom to contact if delays occur and can follow up when necessary. Proactively engaging with the system ensures you get the care you need without unnecessary stress.

FAQ

What should you do if you lose your referral letter?

Contact your GP practice immediately. They can provide a duplicate or resend the referral details to the specialist. Keep a digital or physical copy of all referral-related documents to avoid this issue in the future.

What happens if you miss your specialist appointment?

Inform the hospital or clinic as soon as possible. They may reschedule your appointment. Repeatedly missing appointments could delay your care. Always check the appointment details and set reminders to avoid missing important dates.

What if you want a second opinion after a referral?

You have the right to request a second opinion. Speak to your GP or specialist about your concerns. They can guide you through the process and arrange another consultation with a different specialist if necessary.

What should you do if you move to a new area during the referral process?

Inform your GP and the specialist service about your move. Update your contact details to ensure you receive all correspondence. You may need to register with a new GP, who can help transfer your referral to a local specialist.

What if you feel your referral is taking too long?

Contact your GP to check the status of your referral. You can also call the specialist service directly. If delays persist, ask about alternative hospitals or clinics with shorter waiting times. Staying proactive helps you avoid unnecessary delays.

Tip: Keep a record of all communications related to your referral. This ensures you have accurate information when following up.