Claire Levene
Solicitor
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Solicitor | Medical Negligence
New Referral Service – ‘Advice and Guidance’
The British Medical Journal (BMJ) has reported that patients may be at risk as a result of NHS England’s new “advice and guidance” referral rules, which come into force on 1 April 2026.
According to the NHS England website, NHS Advice and Guidance is defined as:
“Non-face-to-face activity delivered by consultant-led services which can be:
Synchronous (for example, a telephone call)
Asynchronous (enabled electronically through the NHS e-Referral Service, or through other agreed IT platforms or email addresses)”
How the New System Will Work
NHS England intends that the new scheme will allow GPs to seek advice from a specialist doctor prior to, or instead of, making a referral in the way that would have been done previously.
They state that the new advice and guidance system will enable GPs to:
- Ask a specialist for advice or a recommended treatment plan
- Seek clarification regarding a patient’s test results
- Obtain guidance on the appropriateness of a referral
- Identify the most clinically appropriate service where there is uncertainty
NHS England has indicated that outpatient hospital appointments have increased significantly over the last 10 years. It is believed that the new system will help to reduce these appointments by around 25%, with the aim of shortening waiting times.
Concerns Raised by GPs
The BMJ reports that senior GPs are concerned the advice and guidance scheme may, in some cases, delay patient care and reduce GP autonomy.
This is because the scheme requires GPs to seek advice from a specialist before making a referral. Requests will be submitted electronically and reviewed remotely by a specialist clinician, who will then advise whether a patient should be added to a waiting list.
Response times will be agreed between NHS Trusts and primary care commissioning teams but are expected to range between two and five days.
Potential Impact on Patients
While the aim of the scheme is to reduce waiting times, there are concerns that it may increase GP workload.
Many patients already experience difficulty securing GP appointments, often needing to book weeks in advance. There is concern that the new system may make it more difficult or take longer to access a GP, potentially shifting pressure within the system rather than resolving it.
Could This Lead to More Medical Negligence Claims?
It remains to be seen whether the new advice and guidance scheme will contribute to an increase in medical negligence claims involving delays in diagnosis and treatment.
We regularly see claims arising from administrative errors and delays, and it is possible that the introduction of this referral system could increase the risk of such issues occurring.
How We Can Help
If you would like to explore the possibility of bringing a medical negligence claim, please contact contact our specialist team.
Call us on 0151 306 3694 to discuss making a claim on a no win, no fee basis, or email ab@phoenixlegalsolicitors.co.uk.
0151 306 3694 ab@phoenixlegalsolicitors.co.uk