Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what is the expected overall value of additional payments to be made to GPs from seeking advice and guidance from hospital consultants for at least 25 per cent of certain referrals in each of the next three years.

The Neighbourhood Health Framework sets out an ambition to improve how patients are directed to the most appropriate care, including through better use of Advice and Guidance (A&G) between general practices (GPs) and specialist services. There is no target for A&G. The 25% diversion rate referenced in the Neighbourhood Health Framework is based on learning seen in areas where this model is already working well and demonstrates the potential benefit to other systems. The importance of clinical judgment remains unchanged, that if a patient needs a hospital referral, they will get one.

The 2026/27 GP Contract embeds the £82 million of funding from the previous A&G enhanced service into core practice funding. Embedding A&G in the core contract recognises it as routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways.

No separate payments will be made to GPs for each A&G request. As such, the Department has not set an expected overall value of additional payments to be made to GPs seeking A&G from hospital consultants.

The GP Contract does not mandate the use of A&G in all circumstances. Instead, as per the Medium-Term Planning Framework published in October 2025, providers are expected to prioritise A&G prior to or in place of a planned care referral for at least ten specialties, selected locally for the greatest overall benefit and to shape delivery of elective pathways. This does not take away a GP’s right to refer, which remains a matter of clinical judgement. This reflects longstanding planned‑care referral practice and does not alter existing legal or professional accountability frameworks for GPs.

A&G is designed to support quicker, clearer clinical decision making, by enabling GPs and specialist to discuss and agree the most appropriate next steps for a patient. A&G avoids patients having to join lengthy hospital waiting lists and undertake unnecessary appointments where this is in the patient’s best interests and where care can be delivered closer to home. Direct advice from specialists supports joint working between primary and secondary care. Between April 2025 and November 2025, A&G has avoided 1.1 million patients being added to waiting lists, ensuring patients receive the care they need in primary and community settings where appropriate, instead of being added to the elective waiting list unnecessarily.