Trustwide Analysis of Referrals

Reference: 25-26349

Date response sent: 25/11/2025

Details of enquiry

I’m interested in information on the following regarding referrals in your Trust.

1. The total number of referrals received per year / per month
2. Average time taken to triage a referral
3. Process for triaging referrals – is this a paper process or electronic?
4. If electronic, what system(s) are used?
5. Number or % of referrals rejected (inappropriate/ incomplete/ needing further investigations)
6. Is there a dedicated referrals team?
7. Is so please provide a breakdown of roles and bands and number of WTE

Response sent

1. The total number of referrals received per year / per month

This data is provided below.  Please note that we only treat NHS patients.

When a referral is received, it is processed and some referrals may be automatically rejected. The criteria for automatic rejection vary between departments. For example, a referral will be rejected if the patient’s NHS number is missing.

For clarity, we have split the referrals into 2 groups; Mental Health Services, and Gender Identity Services.

2. Average time taken to triage a referral

This varies considerably throughout the Trust.  Full triage of a referral can take as much as several weeks, or a few days and can even be as short as under an hour depending on the department and/or the presenting condition/details provided.  The point of triage in the patient’s journey can range from receipt of referral to once the patient has been on a waiting list, and is due to be offered an appointment.

Our Electronic Patient Records System (EPR) does not carry electronic data fields for entering triage start and end dates/times, so we cannot run any automated reports nor electronically calculate an average time taken for triage of a referral over a given period.

Triage timelines information on accepted patients held would be located within freetext notes sections within patient’s EPR, which is not in an electronically searchable/retrievable format, (ie s no automated mechanism for collation of required freetext data), and would require manual review and processing of a large volume of data, considerably exceeding the limit to time and resource provisioned under the Freedom of Information Act 2000 (FOIA).

Under Section 12 of FOIA the Trust is not obligated to comply with a request for information if we estimate that the costs of complying with the request would exceed the appropriate limit of 18 hours of officer time

The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 has set the appropriate limit as £450 based on a generic charge of £25 per hour to determine whether the Trust holds the information, to locate, and then to extract it. (18 hours X £25 = £450.)

We have estimated that to obtain the requested information, where held, would require a manual search of all patient referrals and first appointments in 2024, amounting to thousands of electronic patient files, which, at an estimated 20 minutes per record would take approximately 333 hours per thousand records.

Section 12 of FOIA further states that the authority (ie this Trust) is not obligated to comply with a request for information if the authority estimates that the costs of complying with the request would exceed the appropriate limit.

Conclusion:  The Trust confirms that it probably holds this data set, but as there is no automated mechanism for its collation of the requested triage data we must advise that we cannot extract this to answer this question within the resources provisioned under FOIA.

This means that as the time required to process this question falls outside the cost limit, this question is therefore refused and exemption from disclosure has been engaged under s12 of FOIA.

3. Process for triaging referrals – is this a paper process or electronic?

These details would be entered into the patient’s EPR (Electronic Patient Record) from either a Word document, received via email, and also electronic via the NHS electronic referral system (ERS) from GPs.

We also accept referrals by post which are scanned and filed electronically.

4. If electronic, what system(s) are used?

Carenotes

5. Number or % of referrals rejected (inappropriate/ incomplete/ needing further investigations)

6. Is there a dedicated referrals team?

Some departments have a dedicated referrals team, such as the Portman Clinic which provides long-term specialist support and help, and Camden CAMHS who triage referrals by making decisions about suitability and the correct team for assessment/treatment. They also support those whose referrals we cannot accept to access more appropriate care.

Most services within the Trust manage the triage process from within their teams, via at least one Band 8a/8b Clinical Lead supported by admin staff as part of their business as usual activity.

We have two services with dedicated intake teams; Camden CAMHS and Portman Clinic services, for triage as well as provide support for rejected referrals to access more appropriate care.

7. Is so please provide a breakdown of roles and bands and number of WTE

Please see our response to Question 6 above.  We have two departments with dedicated referral/triage teams and their staffing range is as shown below:

1. a) The Portman Clinic who manage referrals is staffed as follows:

0.2WTE                  1 person       Band 8b, Clinical Intake Coordinator

1.0 WTE                 1 person       Band 4, Intake Administrator

1. b) Our Camden CAMHS intake team who manage referrals is staffed as follows:

0.6 WTE,                1 person       Band 8B, Team Clinical Lead

1.0 WTE,                1 person       Band 8A, Highly Specialist Clinician

1.8 WTE,                4 people        Band 7,   Specialist Clinicians

0.6 WTE                 1 person       Band 6,   CAMHS clinician