The Healthwatch report revealed 14% of patients are stuck in a ‘black hole' between their GP and hospital teams.

Chris McCann, deputy chief executive at Healthwatch England, said: ‘Behind every delayed, lost, or rejected referral is a human story of pain, stress and uncertainty. And while improvements have been made, too many people remain stuck in the referral "black hole", telling us they're "existing, not living" due to delays.'

The findings followed the introduction of several initiatives to improve the referral process, including: using the NHS App to give patients greater visibility of their referral; piloting the use of pharmacies to refer people with suspected cancer; and enabling GPs to get expert advice before making a formal referral to help direct patients to the right care they need more quickly.   

The research found that while the percentage of patients falling into the referrals black hole had fallen from one in the five (21%) in 2023, many patients still reported poor communication and delays.  

Healthwatch called for a referrals checklist with clear responsibilities across NHS teams, accurate waiting time estimates and rapid implementation of Jess' Rule to ensure patients are referred when health issues remain unresolved.

A Department of Health and Social Care spokesperson said: ‘This is not acceptable and we have been clear it will take time to turn around the NHS but we are starting to see improvements.

‘We are supporting general practice with an additional £1.1bn, recruiting more GPs and cutting red tape so they spend more time treating patients.

‘Since this polling was conducted in March, patient satisfaction with primary care has risen from 60% in July 2024 to 75% today.

‘Thanks to our record investment in the NHS, waiting lists have fallen by over 230,000. There's a long way to go, but we are beginning to see the green shoots of recovery in the NHS.'

The Government has published advice to support doctors to go direct to specialists.

Jess' Rule, which was launched in September, asks GPs to think again if, after three appointments, they have been unable to offer a substantiated diagnosis, or the patient's symptoms have escalated.