Kent Surgeon Welcomes Government Pause on Mandatory GP Referral Changes

NHS England had planned to make Advice and Guidance (A&G) mandatory from April 2026. The system would have required GPs to seek specialist advice before referring patients in 10 specialties where clinically appropriate.

But the government has now paused the mandatory aspect following opposition from the British Medical Association. GPs raised concerns over patient safety, increased workload and rejected referrals.

What Advice and Guidance Means

A&G allows GPs to seek non-face-to-face specialist advice from hospital doctors before referring patients. The system was introduced around 10 years ago and expanded after COVID.

Under the original plans, the current A&G Enhanced Service would have been retired. Its £82 million funding was set to be integrated into core GP practice funding as part of a wider £485 million contract uplift.

The total GP contract funding for 2026/27 stands at £13,863 million. This includes the embedded A&G funding alongside other changes like removing “call-back” requirements for patient contact.

The Safety Concerns

Scarlett McNally, a surgeon and BMJ contributor, wrote about her relief at the pause. She highlighted worries that the mandatory system could delay urgent care and lead to inappropriate rejections by hospital specialists.

The dispute between BMA GPs and the government escalated from October 2025. Contract changes including online requests and GP Connect access led to 99% rejection of the imposed contract by GPs.

NHS England has clarified that no national target exists for diverting one in four GP referrals back via A&G. This addresses fears that hospitals would reject appropriate referrals to meet quotas.

Mixed Views on the Changes

NHS England maintains that A&G embedding supports timely specialist input. Officials argue it reduces unnecessary referrals and ensures patients receive care in the right setting.

The BMA welcomes the A&G adjustment as significant progress. But the organisation says demands remain on mitigating unsafe patient demand and improving contract funding.

Pre-referral A&G requests were set to reach up to 4 million in 2025/26, up from 2.4 million in 2023/24. The pause may affect these projected figures.

Key Takeaways

• Government pauses mandatory “advice and guidance” referrals for GPs following safety concerns raised by medical professionals
• £82 million A&G funding still being integrated into core GP contract worth £13,863 million total for 2026/27
• Surgeon expresses relief over pause, citing worries about delayed urgent care and inappropriate hospital rejections

What This Means for Kent Residents

Kent GPs under NHS Kent and Medway Integrated Care Board will still follow locally agreed A&G pathways, but without the mandatory requirement that sparked safety fears. The pause reduces immediate workload pressure on Kent general practices already facing high demand, though risks remain if rejected A&G requests delay specialist access for local patients. If you’re waiting for a hospital referral, ensure your GP includes full clinical details in any advice requests to Kent hospitals like East Kent Hospitals University NHS Foundation Trust to avoid unnecessary delays.