Can I refer patients to the two-week wait as a private GP?
The two-week wait target has been replaced, and NHS England now expects local systems to accept urgent suspected cancer referrals from private GPs. How to make one safely.
- England
The short answer
Yes, in England: the two-week wait target was retired in October 2023, the referral is now called an urgent suspected cancer referral, and NHS England’s cancer waiting times guidance (version 12.1, in effect from 1 July 2025) says local systems should have processes to accept these referrals directly from the independent sector, including private GPs, when the patient meets the usual referral criteria and is eligible for NHS care. Find your local route before you need it, send the referral securely, and track it until the patient has been seen.
Key points
- The two-week wait standard ended in October 2023. Performance is now measured by the 28-day Faster Diagnosis Standard.
- NHS England guidance in effect from 1 July 2025 says systems should have processes for direct urgent suspected cancer referrals from the independent sector, including private GPs.
- The patient must meet normal referral criteria, such as NICE NG12, and be eligible for NHS care.
- Most areas have no e-RS access for private GPs, so you need the local proforma and a secure way to send it.
- You are responsible for making sure the referral arrives and the patient is seen.
What has changed
Two things have changed since the original version of this article.
First, the name. From 1 October 2023 NHS England retired the two-week wait standard and moved to three cancer standards: the 28-day Faster Diagnosis Standard, a 31-day decision-to-treat standard and a 62-day referral-to-treatment standard. The Faster Diagnosis Standard measures whether patients are told they have cancer, or that cancer has been ruled out, within 28 days of referral. The referral itself is now usually called an urgent suspected cancer referral, although many clinicians still say "two-week wait".
Second, the route for private GPs. NHS England’s national cancer waiting times monitoring dataset guidance lists who can make urgent suspected cancer referrals: GPs, dentists, optometrists, and other sources agreed locally. From 1 July 2025 it adds that systems should have processes to enable direct referrals from the independent sector where the patient meets normal referral criteria and is eligible for NHS care. It says this includes patients being seen by a private GP or consultant whose investigations are suspicious of cancer.
Use the same criteria as the NHS
The referral must meet the same thresholds an NHS GP would use. In England that means NICE guideline NG12, Suspected cancer: recognition and referral, which NICE has updated several times in 2025 and 2026. Check the current version rather than relying on memory, as some recommendations and thresholds have changed. Many areas also have local pathways for particular cancers, including direct access tests.
If the patient does not meet the criteria but you are still worried, refer routinely or privately, or discuss with the specialist team. See NHS referrals from private GPs.
How to make the referral
- Find your local route now. Contact the trusts your patients use, or your local cancer alliance, and ask how they accept urgent suspected cancer referrals from the independent sector. Save the proformas and contact details.
- Complete the proforma fully. Include the NHS number, NHS GP practice, contact numbers, relevant results and any access needs.
- Send it securely. Private GPs cannot use the e-Referral Service, so use the route the trust gives you, such as a secure email address. See why private GPs cannot use e-RS.
- Get confirmation of receipt. Do not assume an email arrived. Ask for acknowledgement, and phone if you do not get one the same day.
- Tell the NHS GP. With consent, send a copy to the patient’s NHS practice so they know about the referral and any results.
- Track it. Record the referral and set a reminder to check the patient has an appointment within a few days.
Talking to the patient
Explain that an urgent referral does not mean they have cancer, and that Cancer Research UK says more than 9 out of 10 people referred this way are not diagnosed with cancer. Tell them the hospital may contact them quickly, possibly by phone from an unknown number, and that they should keep their contact details up to date and accept the appointment offered. Give them your contact details and ask them to tell you if they have not heard within the timescale you agreed.
If there is no local route
As far as we are aware, trusts are accepting these referrals in line with the guidance, but processes still vary and some systems are still putting theirs in place. If a trust will not accept your referral:
- point to the section of NHS England’s cancer waiting times guidance on independent sector referrals and ask for it to be escalated
- in the meantime, do not simply hand the patient a letter and ask them to see their NHS GP. With consent, phone the NHS practice to explain the urgency, send your findings securely, and confirm who is taking the referral forward
- record every step, because responsibility stays with you until someone else has clearly accepted it
After the referral
A patient referred on an urgent pathway who is then seen in the NHS is treated as an NHS patient for that pathway. NHS England’s guidance includes patients who choose initially to be seen privately but are then referred for NHS treatment. Tell the patient they can continue to see you for other problems, and agree who will pass on results you hold.
Scotland, Wales and Northern Ireland
This guidance applies in England. Scotland and Wales use urgent suspicion of cancer referrals with their own guidelines and targets, and Northern Ireland uses red flag referrals. Check with the local health board or trust whether they accept referrals from private GPs, and follow the relevant national referral guidance.
Frequently asked questions
Is it still called the two-week wait?
Many people still use the term, but the two-week standard was retired in England in October 2023. Referrals are now urgent suspected cancer referrals, measured against the 28-day Faster Diagnosis Standard.
Does my indemnity cover urgent cancer referrals?
Referring is part of normal clinical practice, so it should be covered. Check with your medical defence organisation if you are unsure, especially for remote consultations.
Can I refer for a direct access test instead?
Only if the local service accepts requests from private GPs. Otherwise arrange the test privately, and refer urgently if the result is suspicious.
Should I refer if the patient has private insurance?
Explain both options. The patient can choose NHS or private care, and the NHS route remains open to them whether or not they are insured.
