Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of mandatory pre-referral Advice and Guidance requirements from 1 April 2026 on workload transferred to GP practices, including the workload arising from acting on specialist advice responses, requesting and reviewing diagnostic investigations recommended by specialists, and managing patients while awaiting responses; and whether additional funding has been allocated to reflect that workload transfer.

Advice and Guidance (A&G) is designed to support quicker, clearer clinical decision making, by enabling general practitioners (GPs) and specialists to discuss and agree on the most appropriate next steps for a patient. The 2026/27 GP Contract does not mandate the use of A&G in all circumstances. Instead, practices are expected to use A&G prior to or in place of a planned care referral, where clinically appropriate, and to follow locally agreed referral pathways.

In 2025/26 we introduced a £20 payment for GPs for each A&G request, allocating up to a total of £80 million of new funding, which has supported significant increases in A&G. For 2026/27, this funding is being incorporated into the GP Contract to provide a consistent, streamlined approach that recognises the vital role of GPs in delivering A&G. Embedding A&G in the GP Contract recognises it as routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways.

We are investing £485 million in GPs in 2026/27, bringing the total spend on the GP Contract to over £13.8 billion. This builds on last year’s £1.1 billion of investment. This uplift represents a 3.6% cash increase, or 1.4% real terms increase, and includes an assumed pay increase of 2.5%. As with previous years, we have asked the independent pay review body for Doctors' and Dentists' Remuneration, for a pay recommendation for 2026/27 for the Government to consider.