General practice is delivering at record levels. NHS data published in late July 2025 shows that hardworking GP teams carried out 383.3 million appointments in the last 12 months, compared to 375.7 million in the previous year – that's over 7 million additional appointments. June 2025 alone saw 31.4 million appointments – the highest ever recorded for the month, representing a 31.9% increase compared to pre-pandemic levels.
This represents an extraordinary commitment from primary care teams who continue to be the front door to healthcare for most patients.
However, this surge in activity comes at a time when GP practices are already stretched to capacity. With appointment demand continuing to rise and workforce pressures mounting, every minute of clinical time has become precious. The challenge isn't just about seeing more patients; it's about ensuring that each interaction delivers maximum value for both patient and clinician.
What really struck me when reviewing these figures was the hidden story they don't tell.
What these headline figures don't reveal is the administrative burden that accompanies this increased activity. More appointments inevitably lead to more referrals, and each referral represents a significant time investment beyond the initial consultation. GPs must navigate complex referral criteria, complete lengthy forms, and often engage in time-consuming back-and-forth with secondary care when information is missing or unclear.
Our experience working with NHS trusts across England reveals that inappropriate or incomplete referrals create a cascade of inefficiency. When referrals are rejected or require additional information, it not only delays patient care but also generates additional administrative work for already pressured GP practices. This creates a cycle where clinical time is diverted from direct patient care to managing referral complications.
I've seen practices where GPs spend as much time managing referral rejections and follow-ups as they do on initial consultations. That's not sustainable.
The financial implications are equally concerning. With GP practices operating under increasing financial pressure, time spent on referral-related administrative tasks represents a direct cost. When we calculate the true cost of a referral rejection – including the initial GP time, administrative follow-up, and eventual re-referral – the figures quickly become substantial.
At East Suffolk and North Essex NHS Foundation Trust, their infertility service was experiencing 36% inappropriate referrals from GP practices before implementing our SMART referral form. Each inappropriate referral represented not just wasted secondary care resources, but also significant GP time that could have been better utilised for direct patient care.
When you multiply this across all specialties and all practices, the scale of wasted resources becomes quite sobering.
The answer lies in intelligent referral management that supports rather than burdens clinical workflows. SMART referral forms transform the referral process from a source of inefficiency into a clinical decision support tool.
Our automated field population eliminates repetitive data entry, whilst clinical calculations ensure accuracy without additional GP time investment. Show and hide functionality means forms adapt intelligently to clinical selections, capturing exactly the right information whilst keeping unnecessary sections hidden. Mandatory fields functionality guarantees that referrals contain all essential information providers need, preventing the administrative back-and-forth that often leads to delays or rejections.
But here's what's really important – this isn't about adding more technology burden to already busy practices. It's about making existing processes work better. Every form is bespoke, tailored specifically to local service requirements rather than generic one-size-fits-all solutions.
The impact is measurable. In high-volume specialties like MSK, which handle thousands of referrals each month, the improvements are particularly significant. At Circle Health Group, Harry Vickers told us: "The SMART form has been an excellent tool to streamline referrals and ensure patients are triaged to the right place, at the right time."
The results speak for themselves. The MSK referral process has been transformed, with significantly reduced referral rejections and improved patient triaging. Plus, when referral data gets saved to patient records, it's automatically coded back to improve QOF indicators – supporting practice productivity beyond just the referral process itself.
This isn't just about secondary care efficiency, it's about giving GPs back time to focus on what they do best: providing direct patient care. And with 383 million appointments to manage, that time saving becomes transformational.
The NHS 10-Year Health Plan emphasises the shift from "analogue to digital", recognising that technology must reduce rather than increase administrative burden. SMART referrals align perfectly with this vision, providing intelligent automation that supports clinical decision-making whilst reducing administrative overhead.
Our platform architecture is designed to support the NHS's future connectivity goals, potentially addressing the "redundant log-ins" issue that government policy identifies as wasting clinical time.
The government wants 2% year-on-year productivity gains. SMART referral management delivers exactly that – proven efficiency improvements that free up clinical capacity for direct patient care.
As GP appointment numbers continue to rise, the need for efficient referral management becomes ever more critical. Getting referrals right the first time benefits everyone: patients receive appropriate care more quickly, GPs spend less time on administrative follow-up, and specialist services can focus their limited capacity on those who need it most.
The technology exists to transform referral management from an administrative burden into intelligent clinical support. But implementation needs to be practical, not just aspirational.
If your organisation is experiencing challenges with referral quality or management, I'd welcome the opportunity to discuss how our approach might help support your clinical teams and improve patient outcomes.
David & the DXS Team
Want to discuss how record GP appointment numbers affect your referral management strategy? Get in touch at hello@dxs-systems.co.uk.
