General practice is often a patient’s first point of contact with the healthcare system. Timely referrals to outpatient care, when clinically appropriate, can improve patient experience and outcomes. GP surgeries in England use the NHS e-Referral Service (e-RS) to refer patients to consultant-led outpatient services, and patients can also use e-RS to book their first hospital or clinic appointment online, by telephone or directly in the GP surgery at the time of referral.
Here we look at how the number of GP referrals has changed over time.
In general, GP referrals fluctuate around 360,000 referrals per week, tending to fall sharply over the Christmas period and recover quickly to normal levels in January. During the winter of 2019-20, the total number of GP referrals halved to 168,532 in the week starting 23 December 2019 and increased to 380,503 in the week starting 20 January 2020.
From the week starting 16 March, the number of referrals began to fall dramatically following the emergence of the coronavirus (Covid-19) pandemic, with NHS trusts being asked to free up inpatient and critical care capacity on 17 March. This may be due to the scaling back of non-urgent elective activity or a reduction in the number of patients presenting at GP surgeries.
The number of GP referrals fell to a low of 53,268 in the week starting 13 April. Referrals for routine cases fell by 90%, urgent referrals fell by 76% and two-week wait referrals for suspected cancer fell by 67%. Over the summer and autumn of 2020, referrals began to increase again. Urgent referrals and referrals for suspected cancer reached similar levels to before the pandemic, but routine referrals remained considerably lower than before the pandemic.
In January 2021, during the third national lockdown, the number of referrals decreased by around 34% compared to January 2020, but has since increased. Referrals fell slightly at the start of April, over the Easter period, but recovered quickly. By the week starting 19 April 2021, there were 236,524 routine referrals, 50,889 urgent referrals, and 60,095 two-week wait referrals for suspected cancer.
About this data
NHS Digital publishes weekly data on referrals, bookings and appointment slot issues through the NHS e-Referral Service (e-RS). The e-RS is used by all GPs in England to make referrals to consultant-led outpatient services and it allows patients to choose their first appointment with a specialist. Bookings can be made online, using the telephone, or directly in the GP surgery at the time of referral.
A referral is defined as a request to another clinician to assist with management of a patient’s health issue. Referral data includes referrals from both CCG and non-CCG organisations for all priorities, specialities and clinic types. The data do not include patients who have had a referral, booking or attempted booking outside of the e-RS system.