My GP did not send referral for 11 months!

[Mydoghealsmyheart]

I saw my GP at the start of January and they agreed to refer me to a specialist. I waited and waited and heard nothing from the hospital and then I enquired about a new patient appointment. I was informed that they had never received any referral! My GP has now admitted that she never made one in January but it’s ok as “it’s been done now”.
I don’t know what I should do about this. I don’t want to complain formally for fear of repercussions. It’s hard enough accessing good, timely healthcare as it is without the surgery resenting me for making a complaint. But the GP’s delay has meant I’ve lost almost an entire year when I should have been on the very long waiting list. Now I have to start all over. I’m likely to need surgery once I’ve seen the specialist so that will be another long wait which is just the way things are right now but the delay for an initial consultation seems so unfair.

Contact the practice manager and discuss it with them.

If that doesn't help try your local PALS

Kick up fuss also call hospital booking and tell them what happens

I’d speak to the practice manager.

Don't do this.

Ask to speak to the GP practice manager tomorrow, this must be very upsetting for you.

Unfortunately the practise manager won't be able to do much

Well yes they can

I work in Camhs and when we lose a referral (happens unfortunately from primary healthcare) then they have to be put on the waiting list at the right point

Surely this will also apply to you?

But the hospital didn't lose the referral so not sure if the above applies

When a referral wasn't done internally at camhs for another part of the camhs system we were put on the list where we would have been if the referral had been made.

That’s very interesting - I managed to speak to CAMHS just this week about a pupil referral that had been made in June for an ADHD assessment. The parent had not heard anything so asked me as SENCo to call. I was told that yes, they had the referral but that they currently don’t hold waiting lists as such. They triage the referral, then depending on the severity of the need will depend on how soon they are seen. Some new referrals will get an appointment within weeks, some within months, some within years.

That's an NDT assessment NOT for therapy though - it's a different list

Unfortunately we have a really stupid system where GP surgeries are responsible for investigating themselves when things go wrong. I've worked in multiple surgeries and the idea that a practice manager can investigate her own boss and find them guilty of anything is utterly laughable. They do not have that kind of freedom to properly investigate and draw independent conclusions. They will ask questions but their job is PR, spin and arse covering.

If you want to take it further and actually get the GP to learn anything from this then you need to get through the initial internal complaints procedure before escalating. The next step is either NHS England or the Parliamentary and Health Service Ombudsman but only if you've received an initial response from the surgery and you aren't happy with it.

The hospital won't be able to help no matter how much noise you make as they never received the referral. When they receive it, something called the RTT pathway is initiated. This is Referral to Treatment time and it's a ticking clock. All of their reportable data is based on this and it really matters when Trusts are reviewed on performance. As your RTT never started there isn't any consequence for them.

I've worked in multiple surgeries and the idea that a practice manager can investigate her own boss and find them guilty of anything is utterly laughable.

No one is saying the practice manager will do this. People are correct stating that the correct point of call here is the practice manager in order to see what can be done about expediting the appointment etc. No one has said anything about an investigation or finding guilt.

@Orange67 the practice manager will not be able to expedite anything, as I've already explained. Hospital Trusts are completely separate to GP surgeries, they can't possibly skip someone to the front of the line because a GP couldn't do their paperwork properly. If they allowed that then how many other GP surgeries would use it as an excuse to become slack with paperwork or use a quick phone call as a way to jump the queue for people. The hospital is assessed on RTT which only commences once the referral is received. For them to fast track the RTT they would need a serious reason like the appointment being changed to an emergency 2 week cancer wait because of different emerging symptoms. The hospital literally owes the GP nothing in this situation and the practice manager won't have a leg to stand on.

GP practices CAN request to expedite referrals at the hospital. The hospital doesn't owe the GP practice anything, no, it's not a favour. It's a genuine mistake that is now affecting a patient.

You have a very negative view. I work in RTT. We don't have people skipping the queue for fun, but occasionally we do fix errors like this as best as we can.

OP, I hope you get sorted.

It's awful. I have done this a couple of times in my career and it is awful when you realise. And no the hospital won't be interested in a delayed referral due to the GPs failings. I would refer and try and see if things could be expedited but often they can't.
The reason to complain is to try and find out what went wrong and to not let it happen again. I had quite strict procedures whereby when I told a patient I would refer I would, in front of them, put it on my task list which is an electronic reminder system. I would then do the referral as soon as the patient left the room and copy and paste the referral letter into the notes as part of the clinical record so all done. But all it takes is a very busy day or an interruption and things can get missed. Putting it on the task list with the patient in the room helped hugely as it was often just as a patient had left we would get interrupted and could forget. Also very satisfying to get to the task list and find you've done all the referrals too!
We do review all our complaints in house but there is the ombudsman if you are not satisfied.
Sorry OP doesn't help you though.

All you can do is ask if the practice can expedite. And next time, check on a weekly basis with the practice whether the referral has been made and ask for a copy.

Do referrals show on the NHS app?

I don't really know why you waited so.long without following up to be honest.

The same happened to DH. I finally got him seen for sleep apnoea and GP said they'd refer to respiratory but told long waits. 6mths later, I called respiratory who had no referral. Called GP and although they never admitted it- clearly hadnt made the referral at all!
DH didnt bother contacting anyone. He was glad to get a CPAP machine. He could exercise, lost 10kg and sleeps much better now.
By all means speak to the practice manager, but I don't know what they could do?
Edit- In hindsight, he should have checked sooner than 6mths later, but this was at the tail end of covid, and considering the GP said they had very long waits, he didn't think to chase weekly/monthly etc.

I always ask for a copy to my email. I am amazed you didn't follow it up before now tbh. It's a shame, and mistakes happen, but lesson learnt. Always follow up within a couple of weeks.

I did check with the hospital a few months ago after allowing enough time to have lapsed from my GP appointment. I then called the surgery soon after to get an update but had to leave a message. Nobody called me back so then I had to call again, leave a message, nobody came back to me. This went on 6 times!

I communicate about all important matters by registered letter to GPs, Hospitals, etc. Very very politely.