Last week the King’s Fund published a report exploring demand for hospital services. The report indicates that over the last 13 years overall referral numbers have risen by 62% – an average of 3% per year. Referrals from GPs specifically have increased from 2.4 million in Q1 2003 to 3.6 million in Q1 2016/17, an overall increase of 51 per cent. While referrals from other sources have grown more rapidly over the same period, from 1.1 million to 2.1 million, an overall increase of 85%. The accelerated increase in non GP referrals is noteworthy, as they now represent a greater proportion of the overall referral figures – 31% in 2003 to 37% in 2016. Consultant-to-Consultant referrals Non GP referrals, which includes Consultant-to-Consultant (C2C) referrals, present a different challenge for the NHS altogether – not least because they are difficult to track. Many commissioners will not readily know the percentage of referrals created by consultants – but given the figures presented here the answer may be more than you might expect. With little mechanism for tracking, let alone controlling C2C referrals, implementing new commissioning policy and ensuring compliance is another significant challenge. The rise in referral numbers, both GP and C2C, emphasise the need for commissioners to gain greater control. Implementing a Single-Point of Access (SPA) can provide an effective mechanism for assessing and triaging all referrals. The outcome of which is consistent application of commissioning policy and vital data extraction – useful for designing new pathways and understanding referral variation. Learn about psHEALTH’s SPA software here, or access the full King’s Fund report here.