NHS England Confirms No National Targets for GP Referral Cuts Under New Advice and Guidance Rules

GPs across Kent can breathe a little easier today after NHS England moved to calm fears about controversial changes to how patients get referred to hospital specialists. The reassurance comes after family doctors warned that new rules could put vulnerable patients at risk by creating pressure to cut referrals.

NHS England confirmed in a letter to GPs dated 24 February 2026 that there will be no national target to reduce GP referrals through the Advice and Guidance scheme. But the service will still become mandatory from April 2026 as part of changes to the GP contract.

What’s Changing This April

The Advice and Guidance service – known as A&G – allows GPs to seek specialist advice from hospital consultants before referring patients. Rather than sending someone straight to a specialist, a GP can ask for guidance on whether the referral is necessary or if the patient can be managed in primary care instead.

From April, Kent GPs working under NHS Kent and Medway Integrated Care Board will be required to use A&G before making planned care referrals in 10 locally agreed specialties. The £82 million funding for the service is being moved from a separate enhanced service into core GP funding.

The government wants to increase pre-referral A&G requests to up to 4 million in 2025/26, up from 2.4 million in 2023/24. A&G was introduced around 10 years ago and expanded after COVID-19 to help tackle growing hospital waiting lists.

Why GPs Are Worried

The Royal College of General Practitioners has raised serious concerns about how the system works in practice. Their survey found that 64% of respondents believe A&G is being used as a referral management tool to simply reduce the number of patients sent to specialists.

Some GPs report that hospital specialists sometimes reject referrals or ask for tests that aren’t available in primary care, creating extra work and potentially delaying care for patients who really need specialist attention.

Yet NHS England maintains that A&G promotes better integrated care and helps ensure patients get the right treatment in the right place.

The Government’s Position

NHS England says the changes will move care closer to home and help specialists focus their time on patients who most need face-to-face appointments. The service excludes suspected cancer referrals, which will continue to follow urgent pathways.

Officials argue that A&G supports peer learning between GPs and specialists while ensuring hospital appointments go to those who need them most.

Key Takeaways

• NHS England confirms no national targets will force GPs to cut referrals through Advice and Guidance from April 2026
• The A&G service becomes mandatory for 10 locally agreed specialties, with £82 million funding moved into core GP contracts
• GP leaders remain concerned the system acts as a barrier to specialist care, with 64% viewing it as a referral management tool

What This Means for Kent Residents

Patients in Kent may find their GP seeks specialist advice before referring them to hospital from April onwards, which could mean fewer unnecessary appointments but potentially longer waits for some specialist care. If you’re concerned about a referral decision, you can discuss this with your local GP practice and ask about the advice received through the A&G system. For urgent health concerns, continue to contact NHS 111 or your GP surgery directly, and remember that suspected cancer referrals remain on fast-track pathways.