The National Institute for Health and Care Excellence requires NHS commissioners and service providers to provide psychosocial support for patients with cancer within a tiered service model, including specialist psychological support. This retrospective audit examined referral patterns to a specialist NHS cancer psychology service (CPS) between 1 April 2023 and 31 March 2024. Referral data (n=507) were collated and compared with local trust data on new cancer diagnoses for the same period. Referral sources, patient demographics and primary tumour sites were analysed to identify potential inequities in access to the CPS. The results showed that referrals were predominantly for women with breast cancer, aged 40-70 years, and most originated from cancer nurse specialists within hospital settings. Patients aged 70 years and older, and those with head and neck cancers, appeared to be underrepresented compared with regional incidence. The audit has established a baseline for monitoring referral patterns and highlighted the need for targeted interventions to ensure equitable access to psycho-oncology services.