Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the impact of mandatory Advice and Guidance requirements on ensuring that appropriate referrals for endometriosis are not delayed or blocked.

The GP Contract does not mandate the use of Advice and Guidance (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 greatest overall benefit and to shape delivery of elective pathways. General practice should be involved in discussions to decide on which ten specialties are the most appropriate. 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 specialists to discuss and agree the most appropriate next steps for a patient, including those with or suspected to have endometriosis. Where the outcome of advice is for care management in the community, we expect patients to be seen more quickly, closer to home, benefiting from earlier specialist input. In these cases, the GP may still subsequently refer their patient at any point if they have concerns.

The Renewed Women’s Health Strategy commits to speeding up diagnosis and access to treatment for women with endometriosis. The strategy announces a new programme to improve education for girls about their menstrual health, investing an additional £1 million to support targeted work in schools and community settings to support girls’ knowledge about menstrual health and when to seek healthcare. This is an important factor to delays in diagnosis and treatment for endometriosis.