Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what his policy is on the professional indemnity arrangements for GPs and hospital consultants in cases arising from Advice and Guidance interactions under the 2026/27 GP contract regulations.

General practitioners (GPs), and other primary care referrers, remain professionally accountable for making appropriate clinical decisions, including referring patients to specialist care when it is in the patient’s best interests. The use of specialist advice requests does not override those responsibilities or place GPs in conflict between contractual and professional obligations. NHS England continues to support clinicians through guidance, pathway design, and local governance arrangements to ensure these arrangements are used safely, proportionately, and in a way that preserves clear clinical accountability.

While advice is being sought or acted on in primary care, the GP remains responsible for the patient’s overall clinical care and risk. The specialist is responsible for the quality and appropriateness of the advice they give, not for ongoing management or follow‑up unless they formally assume responsibility for the patient’s care. Specialists also have clinical responsibility from the point at which a specialist advice request is converted into a referral or if the specialist initiates investigations or treatment directly.

Under this model, requests for specialist advice and referrals are clinically reviewed by a named consultant, with the aim of ensuring patients are directed to the most suitable pathway. Where a local model is already established, or has been agreed between primary and secondary care, that provides timely specialist clinical assessment with clear accountability, this may continue with oversight from a named consultant.

The contract does not change the clinical threshold for referral to specialist care. 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 it is needed. GPs retain responsibility for referral decisions, and this model supports, and does not replace, clinical judgement.

This reflects longstanding planned care referral practice and does not alter existing legal or professional accountability frameworks for GPs.