The finding that one in seven GP referrals are getting lost, with harm to most of the patients involved , is no surprise to me.... I have experienced this myself many times, with investigations and/or outpatient appointments promised but never happening. Sometimes this follows an appointment being cancelled, with a “we will be in contact soon” message that turns out not to be true. Sometimes one just falls off the system, presumably included on a waiting list to be dealt with, that is then not dealt with. My experience is shared by large numbers of patients. The administrators are, in my experience, competent and dedicated people – but the system is not working. The commonly heard complaint that “there’s too much bureaucracy in the NHS” is wrong. What is needed is a well-managed administrative system, where the chief priority is that somebody is responsible for ensuring coordination, and that gaps are filled, eg when an administrator is on leave, ill, or moves to a different job. The present dire situation also means that nurses and doctors have to add administrative tasks to their already-heavy workload, adding to their stress and burnout. Probably it is not just the NHS, but a widespread problem....Good administration is undervalued, probably because everybody seems to be against “bureaucrats” – and politicians are often keen to be seen to cut “bureaucracy”. Michael Joffe London [edited for length for AltText]