Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, in relation to the GP contract 2026/27, how his Department plans to support hospitals in dealing with the increased caseloads generated by mandating Advice and Guidance.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Advice and Guidance (A&G) is a clinical collaboration tool that supports timely specialist input and helps patients receive care in the right setting, enabling best use of clinical time.

The GP Contract 2026/27 sets out that practices will be required to use A&G prior to, or in place of, a planned care referral where clinically appropriate. It also sets out the expectation for practices to follow locally agreed referral pathways, including single point of access (SPoA) models once introduced. Similarly, our Medium-term Planning Framework, published in October 2026, introduced plans to support increased A&G by moving to an elective SPoA model. All appropriate referrals and requests, other than those for urgent suspected cancer, will be directed through a single ‘front door’ to support triage to the most appropriate next step or outcome for the patient. This will help reduce unnecessary appointments, making the best use of clinical time. The Medium-Term Planning Framework set the aim for all referrals to go via a SPoA for at least 10 specialties determined at provider level by October 2026, which provides flexibility for local teams to deliver where there is the most potential for the model to be effective, including ensuring timely responses.

Integrated care boards are expected to support the introduction of expanded A&G and SPoA through their strategic commissioning for 2026/27. National Health Service trusts will continue to be funded to deliver A&G through a fixed payment negotiated locally to ensure predictable and sufficient funding to cover increased A&G use. NHS England will continue to work with systems to monitor performance, share good practice, and support timely responses, including through job planning guidance that supports clinicians to manage A&G safely and appropriately.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, in relation to the GP contract 2026/27, what framework he has put in place to help ensure that hospitals respond to Advice and Guidance requests in a timely manner.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Advice and Guidance (A&G) is a clinical collaboration tool that supports timely specialist input and helps patients receive care in the right setting, enabling best use of clinical time.

The GP Contract 2026/27 sets out that practices will be required to use A&G prior to, or in place of, a planned care referral where clinically appropriate. It also sets out the expectation for practices to follow locally agreed referral pathways, including single point of access (SPoA) models once introduced. Similarly, our Medium-term Planning Framework, published in October 2026, introduced plans to support increased A&G by moving to an elective SPoA model. All appropriate referrals and requests, other than those for urgent suspected cancer, will be directed through a single ‘front door’ to support triage to the most appropriate next step or outcome for the patient. This will help reduce unnecessary appointments, making the best use of clinical time. The Medium-Term Planning Framework set the aim for all referrals to go via a SPoA for at least 10 specialties determined at provider level by October 2026, which provides flexibility for local teams to deliver where there is the most potential for the model to be effective, including ensuring timely responses.

Integrated care boards are expected to support the introduction of expanded A&G and SPoA through their strategic commissioning for 2026/27. National Health Service trusts will continue to be funded to deliver A&G through a fixed payment negotiated locally to ensure predictable and sufficient funding to cover increased A&G use. NHS England will continue to work with systems to monitor performance, share good practice, and support timely responses, including through job planning guidance that supports clinicians to manage A&G safely and appropriately.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, If he will make an assessment of the adequacy of hospice bed capacity and how this is tracked nationally.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

The majority of hospices are charitable, independent organisations and, therefore, the Government does not collect or keep data on hospice bed capacity nationally. There are no current plans to make a formal assessment of the adequacy of hospice bed capacity.

Integrated care boards (ICBs) are responsible for commissioning core and specialist palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality. As part of the MSF, we will consider contracting and commissioning arrangements. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether all hospice services are required to be commissioned.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

The majority of hospices are charitable, independent organisations and, therefore, the Government does not collect or keep data on hospice bed capacity nationally. There are no current plans to make a formal assessment of the adequacy of hospice bed capacity.

Integrated care boards (ICBs) are responsible for commissioning core and specialist palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. Through our MSF, we will closely monitor the shift towards the strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality. As part of the MSF, we will consider contracting and commissioning arrangements. We recognise that there is currently a mix of contracting models in the hospice sector. By supporting ICBs to commission more strategically, we can move away from grant and block contract models. In the long term, this will aid sustainability and help hospices’ ability to plan ahead.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what his planned timetable is for publishing operational guidance for the use of Advice and Guidance in the context of the GP contract 2026/27.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

As part of the usual annual cycle, NHS England will refresh the operational delivery framework to ensure it remains aligned with the updated contractual requirements. The GP Contract changes for 2026/27 are underpinned by regulations, which will be laid before Parliament in the usual way, alongside an explanatory memorandum. Framework updates will happen in line with, or prior to, regulations coming into force. NHS England will continue to ensure that operational delivery frameworks remain clear, robust, and supportive as the use of Advice and Guidance expands.

Question to the Department for Digital, Culture, Media & Sport:

To ask the Secretary of State for Culture, Media and Sport, what discussions she has had with the [i] FA and [ii] other football bodies the use of [a] schools and [b] multi-use sports facilities by local youth football clubs for training and playing matches.

Answered by Stephanie Peacock - Parliamentary Under Secretary of State (Department for Culture, Media and Sport)

The Government is committed to ensuring that everyone, including children and young people, have access to and benefit from quality sport and physical activity opportunities.

In 2026/27, we will invest £85m across the UK via the Multi-Sport Grassroots Facilities (MSGF) Programme, building on the £98m being invested through the programme in 2025/26. This supports communities, including children and young people, to get active through funding artificial grass pitches, floodlights, changing pavilions and other facility improvements.

Last year, the Government announced a new PE and School Sport Partnerships model and a new Enrichment Framework for schools to ensure all young people have equal access to high-quality sport and extracurricular activity. A national network will be developed to build strong partnerships between schools, local clubs and National Governing Bodies to identify and break down barriers to sport for children who are less active. I recently met with colleagues in the Department for Education and the Department for Health and Social Care to discuss this, as we move towards introducing this new approach.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will ask NHS England to set out the definition of ‘clinically urgent’ for patients who need to be dealt with on the same day in the context of the the GP contract 2026/27.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

As part of the 2026/27 GP Contract, we are amending the core contract to explicitly require that requests identified as clinically urgent must be dealt with on the same day. It is for practices to use their clinical judgement to determine which requests are clinically urgent.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to WPQ109839 answered on 9 February on Cerebral Palsy: Young People, whether she will hold discussions with the Equalities Minister on whether current systems within the NHS support young adults with cerebral palsy, including those without a diagnosed learning disability.

Answered by Sharon Hodgson - Parliamentary Under-Secretary (Department of Health and Social Care)

Ministers from the Department of Health and Social Care and the Minister for Equalities work closely together on issues relating to disability, health inequalities and access to services. Officials will continue to engage across Government to ensure that national policy recognises the needs of young adults with cerebral palsy and that systems across the National Health Service support equitable access to appropriate care, regardless of whether an individual has a diagnosed learning disability.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to his Department's publication entitled Changes to the GP contract in 2026/27, updated on 4 March 2025, whether the money to fund the practice-level GP reimbursement scheme will be new funding.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

Following feedback from the 2026/27 GP Contract consultation, we are introducing a practice-level general practice reimbursement scheme using £292 million of repurposed funding from the current Capacity and Access Payment.

This funding will be available to practices to hire additional general practitioners (GPs) or to fund additional sessions with existing GPs to improve access in GPs. This aims to strengthen capacity, access, and improve patient satisfaction, whilst also addressing GP unemployment and underemployment. This is good value for the taxpayer and guarantees the money is spent on GPs.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the GP contract 2026/27, whether every non-cancer referral will need to go through Advice and Guidance.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

As part of the 2026/27 GP Contract, we are embedding the current Advice and Guidance (A&G) enhanced service funding within core practice funding. Practices will be required to use A&G prior to or in place of a planned care referral, where clinically appropriate, and to follow locally agreed referral pathways.

A&G has shown clear value in supporting timely specialist input, reducing unnecessary referrals, and ensuring patients receive timely care in the most appropriate setting.

Between April 2025 and December 2025, A&G has avoided 1.3 million patients being added to waiting lists.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether Advice and Guidance will be mandatory for GPs to use in the context of the GP contract 2026/27.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

As part of the 2026/27 GP Contract, we are embedding the current Advice and Guidance (A&G) enhanced service funding within core practice funding. Practices will be required to use A&G prior to or in place of a planned care referral, where clinically appropriate, and to follow locally agreed referral pathways.

A&G has shown clear value in supporting timely specialist input, reducing unnecessary referrals, and ensuring patients receive timely care in the most appropriate setting.

Between April 2025 and December 2025, A&G has avoided 1.3 million patients being added to waiting lists.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to Question118267 answered on 13 March on General Practitioners: Contracts, what evidence is there to support the statement that the changes made to advice and guidance will reduce the number of unnecessary appointments.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

NHS England collects and publishes national data on total Advice and Guidance (A&G) activity through the existing system elective recovery outpatient collection, published and available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/outpatient-transformation/specialist-advice/

This includes total A&G requests sent, processed requests, where a specialist has returned the advice and diversions, where the outcome of A&G is that a referral is not required. This data is also available at provider and integrated care board levels.

NHS England also collects data on the above by treatment function, or specialty, and on turnaround times of A&G. These are not published but available to National Health Service providers through the Model Health System. During 2026/27, NHS England will review and expand what measures are published as and when additional data becomes available through the expansion and improvements to the electronic referral system platform.

Between April 2025 and November 2025, there were 2,394,266 pre-referral advice and guidance requests, of which 2,210,443 were processed and 1,095,172 have been diverted, which is 45.7% of total requests. Diverted patients may otherwise have had to wait for an unnecessary appointment and instead are expected to receive more timely care with earlier specialist input.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to Question 118267 answered on 13 March on General Practitioners: Contracts, what data will be collected about advice and guidance by NHS England.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

NHS England collects and publishes national data on total Advice and Guidance (A&G) activity through the existing system elective recovery outpatient collection, published and available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/outpatient-transformation/specialist-advice/

This includes total A&G requests sent, processed requests, where a specialist has returned the advice and diversions, where the outcome of A&G is that a referral is not required. This data is also available at provider and integrated care board levels.

NHS England also collects data on the above by treatment function, or specialty, and on turnaround times of A&G. These are not published but available to National Health Service providers through the Model Health System. During 2026/27, NHS England will review and expand what measures are published as and when additional data becomes available through the expansion and improvements to the electronic referral system platform.

Between April 2025 and November 2025, there were 2,394,266 pre-referral advice and guidance requests, of which 2,210,443 were processed and 1,095,172 have been diverted, which is 45.7% of total requests. Diverted patients may otherwise have had to wait for an unnecessary appointment and instead are expected to receive more timely care with earlier specialist input.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to his Department's publication entitled Changes to the GP contract in 2026/27, updated on 4 March 2025, when will the exact requirements for advice and guidance be published.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

As part of the 2026/27 GP Contract, we are embedding the current Advice and Guidance enhanced service funding within core practice funding. The core expectations for general practices (GPs) broadly remain unchanged, and practices will be required to use Advice and Guidance prior to or in place of a planned care referral, where clinically appropriate, and to follow locally agreed referral pathways.

As part of the usual annual cycle, NHS England will refresh the operational delivery framework to ensure it remains aligned with the updated contractual requirements. The GP Contract changes for 2026/27 are underpinned by regulations, which will be laid before Parliament in the usual way, alongside an explanatory memorandum. Framework updates will happen in line with, or prior to, regulations coming into force. NHS England will continue to ensure that operational delivery frameworks remain clear, robust, and supportive as the use of Advice and Guidance expands. A draft technical guidance is already available to ICBs to support preparation for implementation.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to Question 118267 answered on 13 March on General Practitioners: Contracts, who is clinically responsible for the patient while advice and guidance is being sought; and at what point does that responsibility transfer to secondary care.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Currently, a patient is added to an official waiting list when an Advice and Guidance request is converted into a referral. This will remain the case through part of 2026/27. From October 2026, expanded Advice and Guidance will be routed through a new Elective Single Point of Access (SPoA), in line with the Medium Term Planning Framework. From this point, while a patient will still be added onto a waiting list at the point of the referral being accepted, their waiting time will be calculated from the date the Advice and Guidance request or referral was received by the SpoA.

While advice is being sought and acted on in primary care, the general practitioner remains responsible for the patient’s overall clinical care and risk. The specialist is responsible for the quality and appropriateness of the advice they give, not for ongoing management or follow‑up unless they formally take the patient on. Specialist also have clinical responsibility from the point an Advice and Guidance request is converted into a referral or if the specialist initiates investigations or treatment directly.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to his Department's publication entitled Changes to the GP contract in 2026/27, updated on 4 March 2025, at what point during the process of advice and guidance will his Department add a patient to an official NHS waiting list.

Answered by Karin Smyth - Minister of State (Department of Health and Social Care)

Currently, a patient is added to an official waiting list when an Advice and Guidance request is converted into a referral. This will remain the case through part of 2026/27. From October 2026, expanded Advice and Guidance will be routed through a new Elective Single Point of Access (SPoA), in line with the Medium Term Planning Framework. From this point, while a patient will still be added onto a waiting list at the point of the referral being accepted, their waiting time will be calculated from the date the Advice and Guidance request or referral was received by the SpoA.

While advice is being sought and acted on in primary care, the general practitioner remains responsible for the patient’s overall clinical care and risk. The specialist is responsible for the quality and appropriateness of the advice they give, not for ongoing management or follow‑up unless they formally take the patient on. Specialist also have clinical responsibility from the point an Advice and Guidance request is converted into a referral or if the specialist initiates investigations or treatment directly.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to his Department's publication entitled Changes to the GP contract in 2026/27, updated on 4 March 2025, whether he has made an assessment of the impact of removing the cap on online requests that can be submitted during core hours on (a) patient safety and (b) GP workload.

Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)

The Department has not made a specific assessment of the impact of removing the caps on online requests on patient safety and general practice (GP) workload. Data on online consultation submissions is collected, monitored, and published.

This is because there is no change to clinical responsibility, triage processes, or same‑day requirements for clinically urgent care as a result of this clarification. Practices retain flexibility over how requests are prioritised and responded to, including the use of triage models and appropriate response times for non‑urgent requests. Evidence from practices shows that spreading demand more evenly across the day can support smoother workflows and reduce pressure on telephone access, rather than increasing overall workload.

The clarification on online access is being implemented alongside wider GP Contract changes for 2026/27, including £485 million in additional core funding and reforms intended to support practice capacity.