MORE than one in four GP referrals are being rejected by hospitals, sparking concerns over cancer treatment delays, new research has revealed.

Family doctors estimated 26 per cent of their attempted referrals are being rejected and sent back as advice and guidance (A&G), according to a poll by Pulse magazine.

A&G is designed for GPs to seek specialist advice before making referrals; the unsolicited returns mean patients who doctors had intended to refer to hospital had to go back 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, the survey of 712 GPs found.

The British Medical Association’s GPs committee chairwoman Dr Clare Bannon said: “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.”

One London GP told Pulse that they feel the system is “getting more risky and unsafe” and had contributed to their decision to leave general practice.

Another family doctor in the north-east of England warned that A&G was creating “increasing barriers to two-week-wait gastrointestinal referrals” for patients with red-flag suspected cancer symptoms.

The General Medical Council’s latest workplace report warns six in 10 GPs are struggling  to provide a high standard of care weekly, stating: “GPs remain the most pressurised group in the workforce.”

In response, the Department of Health & Social Care claimed the advice and guidance model has supported millions of patients to “receive care in the right place without having to join elective waiting lists” 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.”

Keep Our NHS Public co-chair Dr John Puntis said: “These findings on rejection of GP referrals fit with an increasing trend over recent years aimed at reducing waiting lists but at the expense of patient safety. 

“GPs understand both the pressure hospital colleagues are under and when it is appropriate for a referral to be made. To then allow someone who has not seen the patient to decide that a referral is unjustified is fraught with danger. 
“It is disingenuous for government to misrepresent blocking GP referrals as successful implementation of care nearer to home. 

“GPs are being put in an impossible position where they cannot provide the standard of care required, trust is eroded and patients pay the price.”