Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the clinical and patient safety implications of mandating general practitioners to use Advice and Guidance prior to referral to specialist care within the 2026–27 GP contract and in what clinical circumstances they intend such a mandate to apply; and how they will ensure that any such mandate does not adversely affect access to specialist care or clear clinical accountability for patient care.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The purpose of Advice and Guidance and an elective Single Point of Access is to ensure patients and practices receive rapid specialist assessment and a clear next step, using modern referral and triage approaches. It is important to emphasise that the clinical threshold for a referral remains unchanged.

Where there is clear clinical evidence, the intention is to avoid adding patients to outpatient waiting lists when they can receive timely diagnosis, advice, or management in a more appropriate setting. General practitioners (GPs) should continue to make a clinical decision to refer for specialist care where that is in the patient’s best interests, and to request specialist advice where that is needed. GPs retain responsibility for referral decisions, and this model supports and does not replace or override clinical judgement.

GPs, and other primary care referrers, remain professionally and legally accountable for their clinical decisions, including referring patients to specialist care where this is in the patient’s best interests. Requests for referral or specialist advice will receive a response from a named consultant with clear accountability and oversight.

The 2026/27 GP Contract embeds the previous Advice and Guidance enhanced service funding into core practice funding. Following near universal uptake of the Advice and Guidance Enhanced Service in 2025/26, the focus for 2026/27 is on stability and simplicity. Embedding the specialist advice model within the core contract recognises its role in routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways.

Found: 18th June The Committee met in Committee Room 3 Present: Baroness Barran (Acting Chair) Baroness Gerada

Found: Apologies and notices Apologies were received from the Lord Bishop of Derby, Baroness Gerada

Found: Apologies and notices Apologies were received from the Lord Bishop of Derby, Baroness Gerada

Found: The Committee met in Committee Room 1 Present: Baroness Kennedy of The Shaws (Chair) Baroness Gerada

Found: Baroness Gerada: I was going to ask a very similar question.

Found: Thursday 18 June 2026 11.40 am Watch the meeting Members present: Baroness Barran (The Chair); Baroness Gerada

Found: Thursday 18 June 2026 10.35 am Watch the meeting Members present: Baroness Barran (The Chair); Baroness Gerada

Found: Can I move to you, Baroness Gerada?

Found: Meeting, held at 10:30am on Thursday, 21st May Present: Baroness Barran (acting as Chair) Baroness Gerada

Found: 2026 11.50 am Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Gerada

Found: 2026 11.50 am Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Gerada

Found: 2026 10.30 am Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Gerada

Found: 2026 10.30 am Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Gerada

Found: Thursday 21 May 2026 11.40 am Watch the meeting Members present: Baroness Barran (in the Chair); Baroness Gerada

Found: Thursday 21 May 2026 10.40 am Watch the meeting Members present: Baroness Barran (The Chair); Baroness Gerada

Found: 2026 11.45 am Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Gerada

Found: 2026 10.40 am Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Gerada

Found: Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Barran; Baroness Gerada

Found: Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Barran; Baroness Gerada

Found: Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Barran; Baroness Gerada

Found: Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Barran; Baroness Gerada

Found: Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Barran; Baroness Gerada

Found: Watch the meeting Members present: Baroness Kennedy of The Shaws (The Chair); Baroness Barran; Baroness Gerada