What to do when an NHS referral or promised follow-up has stalled

Katerina Galkina · EN · 07/10/2026

If a GP promised a referral but no letter or appointment has arrived, establish where the process has stopped. The referral may await sending, assessment by the receiving team or action from you. Assess your current health separately: administrative follow-up does not replace medical care if your condition deteriorates.

Confirm exactly what was sent

Ask the GP surgery to check the sending date, specialty, receiving organisation and priority. Ask whether the NHS e-Referral Service is being used and whether you need booking details. Manage Your Referral ↗ normally requires a reference and access code; the NHS advises contacting the referring organisation if you do not have them.

Make a short record of the consultation date, promised next step, referral date and destination. Specify which referral you mean if there are several. Check whether it was returned for further information and whether anyone needs to respond. This is more useful than repeatedly asking only when you will be seen.

Check receipt and triage with the receiving service

Use the hospital trust's official website or details on its letter. Ask whether the referral has arrived and whether it is awaiting clinical triage, booking, a waiting-list place or clarification. Check your current address and telephone number so correspondence is not sent to old details.

Ask how the service will contact you and when to follow up again. If it cannot locate the referral, give that response to the GP and ask them to check delivery or take the necessary next action. Do not independently create a duplicate or cancel a request without discussion: linked actions may already be in progress.

Understand the waiting-time rules

For certain planned consultant-led services in England, there is a right to start treatment within 18 weeks, with exceptions. This is not a universal guarantee of a face-to-face appointment with any specialist within that period. When the clock starts and whether the right applies depend on the pathway. See NHS waiting-time guidance ↗.

If the applicable maximum is likely to be exceeded, discuss a suitable alternative with the provider or ICB. The NHS Choice Framework ↗ sets out conditions and exceptions. Urgent suspected-cancer referrals have different standards; follow these letters carefully rather than simply waiting for the general limit.

Ask for organisational help

For a problem within a hospital, contact PALS ↗. Provide a short timeline, reference, previous replies and a clear request: confirm receipt, identify a waiting-list contact or explain the next step. PALS helps resolve problems but does not replace a clinician or guarantee priority treatment.

At a GP surgery, start with reception or the practice manager. A formal complaint can go to the provider or commissioner, usually the local ICB. NHS England explains the process ↗: do not launch the same formal complaint with both as separate proceedings. Explain what needs putting right and include your contact history.

Agree clinical care while you wait

Ask your GP how to manage the problem before the specialist appointment, which changes require earlier contact and who is responsible for current prescriptions. The NHS recommends clarifying next steps and what to do if you worsen ↗. Report new symptoms separately rather than only in a delay complaint.

For urgent needs, contact your GP or NHS 111; call 999 for a life-threatening emergency. You do not need to pay an intermediary to check an NHS referral, use PALS or complain. Moving to self-pay requires a separate cost assessment and does not automatically transfer the NHS care plan. This guide covers England and was checked on 7 October 2026.