NHS England’s plans to replace traditional GP referrals

An NHS England document has confirmed that that it wants to ‘optimise’ GP referrals to secondary care via an enhanced model of advice and guidance.

GP leaders recently raised concerns that NHS England had encouraged Integrated Care Boards (ICBs) to adopt the ‘advice and refer’ model, effectively replacing traditional GP referrals and adding barriers for patients in accessing secondary care. 

At the time, NHS England did not address concerns about this specific model, but Pulse has now seen a ‘framework’ document which encouraged local commissioners to ‘strengthen’ specialist advice services in order to ‘optimise’ referrals. 

The guidance suggested the use of the ‘advice and refer’ model, which means all referrals or advice requests from GPs ‘come in through one route’ and directly bookable appointments are ‘discouraged or removed’.

Under this service, all referrals are then ‘triaged’, allowing hospitals to reject referrals and send them back to GPs with advice. 

This mechanism removes the option for GPs to send standard referrals, whereas the usual model of advice and guidance (A&G) allows GPs to seek advice if they wish, but maintains the direct referral route.

NHS England emphasised its commitment to empowering regions to ‘develop diverse models’ of specialist advice in line with their local needs.

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Source: Pulse, 26 June 2024