Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 18 March 2026 to Question 119478 on General Practitioners: Contracts, how he defines ‘avoiding’ in the context of avoiding 1.3 million patients being added to a waiting list.

Advice and Guidance (A&G) is a pre‑referral service used to enable general practitioners (GPs) and hospital specialists, including consultants, to work together to make the best care plans for patients, ensuring patients receive care in the most appropriate setting. A&G requests are distinct from hospital referrals, whereby a patient is added onto a waiting list. A&G does not take away a GP’s right to refer, which remains a matter of clinical judgement.

“Avoiding” being added to a waiting list reflects when, following an A&G request, a patient is deemed not to require a secondary care referral at that time. Without A&G, these patients might otherwise have had to wait for an unnecessary appointment and instead are expected to receive more timely care with earlier specialist input. In these cases, the GP may still subsequently refer their patient at any point if they have concerns.

Between April 2025 and December 2025, there were nearly 16 million referrals for Referral to Treatment services. For the same period there were over 1.2 million pre-referral A&G requests directed to treatment that is not a secondary care referral at that time, or 45.9% of total A&G requests, and this figure has been updated to reflect the latest data.

Additionally, the National Director for Primary Care and Community Services set out further information here:

https://www.england.nhs.uk/long-read/letter-specialist-advice-elective-single-point-of-access/