Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, in relation to the Medium Term Planning Framework published by NHS England in October 2025, which 10 specialities each ICB has identified as the most effective for the use of Advice and Guidance.

As set out in the Medium-Term Planning Framework, National Health Service providers of Referral to Treatment consultant-led care are expected to prioritise Advice and Guidance (A&G) across at least ten specialties where it will have the greatest overall benefit. The ten specialties are selected locally at provider-level. General practice should be involved in discussions to decide on which are the most appropriate and we expect integrated care boards (ICBs) to support the use of A&G through their strategic commissioning for 2026/27. We do not centrally hold information regarding which specialties providers have selected.

Regarding the 25% aim, the National Director for Primary Care and Community Services made clear there is no national target. Further information is available at the following link:

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

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. A general practitioner’s (GP’s) clinical decision to refer remains unchanged and GPs should continue to make a clinical decision to refer for specialist care where that is in the patient’s best interest.