Safety watchdog warns patient referrals are vanishing from NHS worklists

Thousands of patients have been affected by a flaw that can silently remove referrals from NHS electronic worklists before an appointment has been booked, a safety investigation has found.

The NHS e-Referral Service automatically removes entries when no action has been recorded for 180 days, without alerting staff. Reported incidents since 2018 include 72 referrals disappearing from one worklist, more than 1,000 patients potentially dropping off another and around 1,000 people having to be added back after waiting six months.

The Health Services Safety Investigations Body said no harm, or no known harm, had been recorded in the cases it examined. However, it warned that the true impact may be underestimated, with lost referrals potentially causing delayed treatment, prolonged symptoms and considerable distress.

NHS organisations have been urged to strengthen their checks and review weekly data showing which referrals have dropped off. NHS England is also updating its clinical risk documentation, although investigators were told that the 180-day function cannot currently be removed because the system was not designed to manage today’s volume of referrals.

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