Track a referral and what "Stale" means

Three places answer "what happened to my referral" without a phone call.

The sent list. In the sidebar, open Referrals, then the Sent tab. Referrals sit in trays by what they need next: Needs you for the ones that went quiet or whose link did not arrive, In motion for the ones with the patient or a practice, Booked, Gone quiet for anything quiet for more than 60 days, and Withdrawn for referrals you withdrew. Every row carries a status pill and its next step, except a withdrawn one, which shows Withdrawn and no next step.

The referral's own page. Open a referral from the list. The top of the page says whose turn it is and what happens next, and History timestamps every step: when the link was delivered, when the patient opened it, when a practice reached out, when a booking landed.

Overview. On your Overview page, Needs you lists the referrals waiting on you, late ones first, including sent ones that went quiet. Select one to open it. Waiting on others shows how many referrals are with patients or other practices, and how long the longest has waited.

A referral moves through four states, each set by a real event rather than by anyone remembering to update it.

• Sent: the referral exists and the secure link is on its way to the patient. Nothing has happened on their side yet.
• Viewed: the patient opened their link and accepted the consent disclosure. They have seen the referral; on a Choice referral this is also when they can start sharing it with a practice.
• In Progress: a receiving practice recorded that it reached out to the patient. Somebody on the other side is working it.
• Booked: an appointment was confirmed, by the practice or by the patient themselves.

Syncroly marks a referral Stale once it is more than 14 days old and still sitting in Sent or Viewed with no booking. The label lands within a day of the fourteenth, not on the hour.

On the list, a stale referral sits in Needs you, or in Gone quiet once it has been quiet for more than 60 days. Its next step says why, so you can triage without opening anything:

• No reply: the patient has not opened their link, or opened it and not agreed to the disclosure. The email may be buried, wrong, or ignored.
• No booking: the patient opened the link and accepted the disclosure, or a receiving practice called them, but nobody has booked. The problem is follow-through, not delivery.

In the referral's History, the same two reasons read Not opened and No booking, and a Stale entry with no reason means the referral was stalled by an account deactivation rather than by inactivity.

A referral marked In Progress is marked stale too, if 14 days pass after a receiving practice last logged contact and it is still not booked. Archiving changes your list, not the referral's status. An archived referral can still become Stale; a withdrawn one cannot.

Nothing is locked and no link is revoked. The referral leaves Stale as soon as something happens: a receiving practice marking contact moves it to In Progress, and a booking moves it to Booked.

Match the fix to the reason. For Not opened, the patient needs the link again, or needs it somewhere else.

If the address itself was wrong, resending to it fixes nothing: use Update details on the same page to correct the email, which also sends a fresh link. A booked referral has no Resend link at all, because there is nothing left for the link to do.

For No booking, the lever is human: in Messages, select the practice to write to it, and on a Choice referral you can also send the referral to one of the practices yourself, which is covered in Direct vs Choice, and which to use.

Not every quiet referral is a problem. On a Choice referral, no receiving practice hears anything until the patient shares with them, so Sent holding for a few days usually means the patient has not opened their link yet, not that the practices are ignoring you. If quiet turns into stalled, the referral says so on its own.