Referrals from GPs to the NHS waiting list are rising

Successive governments have pledged to tackle long waits for elective care. The NHS constitutional Referral-to-Treatment (RTT) target is that 92% of patients should start treatment within 18 weeks of referral, and the government aims to meet this standard by March 2029. 

Recent data highlights the scale of the challenge facing the NHS, however. In June this year, only 66% of patients still waiting to start treatment had been waiting for 18 weeks or less, compared with the 92% standard, while more than 7.2 million cases were waiting to start consultant-led planned NHS care.

While the waiting list remains a closely monitored measure of NHS performance, understanding where these referrals come from is an important part of the picture. The chart below shows weekly GP referral numbers from mid-June 2023 to the end of June this year, with a 12-week trailing average. The trailing average shows a sustained increase in referrals from general practice, from over 194,000 per week in June 2023 to over 227,000 by the end of June this year. This represents a rise of almost 20% over three years. The proportion of referrals from general practice also increased over this period – from 58% to 61%. This indicates that GP referrals are rising both in absolute terms and as a share of overall referrals into consultant-led elective care.

The number of GP referrals highlights the central role of primary care as the main gateway into specialist elective services. Rising numbers of referrals from GPs may reflect the intersection of growing health care need (as the population ages and people spend more time in ill health) with improved access to general practice. Since Labour pledged to end the “8am scramble” for GP appointments, policies to improve access to general practice have included new GP access targets in the NHS England 2025/26 Operational Planning Guidance, and (from last October) a requirement for practices to keep online consultations open throughout core hours.

Alongside these policy changes, the number of FTE GPs is also now rising – increasing capacity in general practice and potentially driving additional referrals. This greater capacity is reflected in the growing number of appointments being delivered, with appointments carried out by GPs rising from 13.7 million in June 2023 to 15.1 million in June this year. Recent GP Patient Survey (GPPS) results also suggest an improvement in patient experience when it comes accessing a GP, with 73% this year saying their overall experience of contacting their GP practice was good, up from 67% in 2024.

However, improved access may not benefit all patients equally. Online booking systems and telephone triage can disadvantage people who have limited access to, or confidence in using, technology. Continued monitoring of GP referral trends will therefore need to consider not only how referral volumes are changing, but also who is being referred, to identify any emerging indicators of inequality in access to care. 

Tracking these trends alongside RTT performance will be essential in understanding whether increased referrals reflect a post-pandemic spike or a sustained increase in demand, and what this means for future waiting times.