Thousands of Patients Accidentally Removed from NHS Waiting Lists, Report Warns

LONDON, October 22: At least 2,000 patients may have been accidentally removed from NHS waiting lists since 2018 due to problems with the health service’s electronic referral system, according to a report by the Health Services Safety Investigations Body (HSSIB).

The report warned that the NHS e-Referral Service (e-RS), used by GPs to refer patients to specialists, was not designed to handle the current volume of referrals, particularly following the COVID-19 pandemic.

The system automatically removes referrals from worklists after 180 days without action. Although this feature was intended to improve system performance, investigators found that it could leave patients at risk of delayed or missed treatment.

In 2018, 72 referrals disappeared from a worklist used when no appointment slots were available. More than 1,000 patients potentially disappeared from the same list in 2019. In 2023/24, around 1,000 patients had to be added back after their referrals were removed following six months of inactivity.

The cases were linked to limited clinic capacity, and the problem came to light after GP practices raised concerns that patients had not received hospital appointments.

Nick Woodier, a senior safety investigator at HSSIB, said patients could face significantly longer waits if their referrals were removed without warning. The report also noted that the scale of the risk remains unclear but may have increased as pressure on outpatient services has grown.

The findings come amid continued pressure on NHS services. NHS England data showed that an estimated 7.37 million treatments were waiting to be carried out at the end of August, affecting 6.24 million patients. More than 113,000 people had been waiting over a year.

HSSIB has urged hospitals and other healthcare providers to strengthen referral-tracking procedures and ensure patients are not lost from waiting lists. NHS England is also updating its national clinical risk guidance to address the issue.

Rachel Power, chief executive of the Patients Association, said patients should not have to chase their own care or worry that their referrals have been lost. She called for clearer accountability, effective tracking systems and adequate administrative support to ensure affected patients are identified and contacted.

The report highlights how administrative and technical failures can have serious consequences for patient safety, particularly when NHS services are already struggling to meet demand.