Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what quality assurance arrangements NHS England has put in place for mandatory Single Point of Access triage decisions from 1 April 2026; what monitoring will be conducted of triage outcomes by specialty and provider; and how GPs and patients will be able to escalate concerns about triage decisions that they consider clinically inappropriate.

We're setting the Advice and Guidance (A&G) clock start so it's the same as outpatient referrals, ensuring no patient will have to wait longer for an appointment as a result of A&G

As set out in the Medium Term Planning Framework, the National Health Service will move toward delivering care through a ‘Single Point of Access’ (SPoA) for all appropriate requests and referrals, excluding for urgent suspected cancer. Under the new SPoA model, if a patient needs treatment, their Referral to Treatment (RTT) clock start date will be calculated from the date the Advice and Guidance (A&G) request or referral was received by the SPoA. This is instead of the current process for A&G, where the clock start date is the date that the request or referral is converted to a treatment pathway. This will ensure that patients' waiting times are accurately reflected.

In February 2026, NHS England issued The Elective Single Point of Access: Technical Guidance for 2026/27 to integrated care boards. This provides guidance on RTT rules and quality assurance arrangements, and advice on establishing leadership and governance structures that ensure SPoA outcomes are assessed regularly. The SPoA will be supported by improvements to the NHS e-Referral Service, which will enable NHS England to collect data on triage outcomes.

SPoA is designed to promote clinical collaboration between primary care referrers and secondary care clinicians, including by facilitating two-way communication and shared decision making. General practitioners (GPs) can re-submit a referral following a SPoA triage outcome if they have concerns about the clinical decision. Escalation routes for concerns about triage decisions will continue to operate through locally agreed referral pathways and communication processes for GPs and patients, supported by improvements to the NHS e-Referral Service. Where patients have concerns regarding outcomes, local Patient Advice and Liaison Service teams can provide advice and support.