General Practice is under significant strain from an aging population, multimorbidity, marked under-resourcing and increased waiting lists post COVID pandemic. Secondary care faces similar pressures, resulting in a growing number of rejected referrals. Multisystem, complex conditions are being redirected to GPs who may lack specialist training in the diagnosis and management of them. Examples include suspected hypermobile Ehlers-Danlos syndromes, fibromyalgia and postural orthostatic tachycardia syndrome.To identify common conditions and issues are being frequently rejected by secondary care across Europe.  Explore and share how GPs are managing these challenges in practice.This workshop will begin with a short presentation outlining the context and real-world examples, followed by interactive roundtable discussions. Participants will discuss experiences and strategies from their respective countries.This workshop will produce a summary of Pan-European challenges and insights on the rising remit of family doctors, which will inform future research and is intended for publication.Rejected referrals are not isolated incidents and they represent a growing systemic challenge across Europe.  GPs are innovating under pressure but the lack of structured training and resources for complex multisystem conditions represents a crucial gap.  Pan-European collaboration is essential to share strategies, develop guidance and advocate for the realistic boundaries of primary care.