Source · Select Committees · Public Accounts Committee
Recommendation 15
15
Accepted
GP advice and guidance scheme demonstrates significant growth in specialist input
Conclusion
NHSE said that it had made progress in some areas, partly where necessity during the Covid 19 pandemic had driven the adoption of technology. NHSE highlighted the advice and guidance scheme, which allows GPs to request specialist input without going through a full referral. This scheme had seen continued growth with 1.1 million requests expected to go through the system this year. To incentivise the use of this system, NHSE are making payments to GPs who have used the system.30 The NAO reported that NHSE had aimed to achieve 16 specialist advice requests for every 100 patients by March 2023. This target was exceeded in the first month of reporting (22 per 100 in June 2022).31 23 Committee of Public Accounts evidence session on 28 November 2022, Managing NHS backlogs and waiting times, see Q98 24 Q 32 25 C&AG’s Report, para 2.26 26 Q 32 27 Q 34 28 Q 66 29 Q 57 30 Qq 43-45 31 C&AG’s Report, para 2.26 10 Delivery of surgical and diagnostic hubs
Government Response Summary
The government acknowledges the importance of monitoring and evaluation of policy development and provides details of progress on A&G, investing in e-RS to support data collections and governance, with the aim of supporting tracking of costs and benefits of A&G by October 2026.
Government Response
Accepted
HM Government
Accepted
3.1 The government agrees with the Committee’s recommendation. Target implementation date: October 2026 3.2 Both NHSE and DHSC recognise the importance of incorporating monitoring and evaluation from the outset of policy development, supported by a robust evidence base where possible, and regular data for monitoring performance. 3.3 'Specialist telephone advice to GPs’ is commonly referred to as A&G and can be utilised via telephone and other communication methods, increasingly through digital channels. 3.4 The department has established data collections that provide regular performance information on A&G. This is used to monitor performance, assure delivery and support evaluation. 3.5 To support data collections and governance of A&G, NHS England is investing in the Electronic Referral Service (e-RS). 3.6 From July 2026, where A&G requests are managed within the e-RS user interface, all referral pathways must support the option to provide A&G, and from October 2026 where a third-party service is used. To support this change during 2026-27 e-RS will be enhanced to provide a breakdown of the types and forms of requests submitted, thus supporting the tracking of costs and benefits of A&G. 3.7 NHSE commissioned North of England Care System Support to produce a detailed review of the costs and benefits of A&G delivery. This report evidences the benefits to patients, clinical teams and health economies. 3.8 Data collections or processes for tracking costs and benefits for the national diagnostics programme have been in place since 2021 and continue to be used to demonstrate progress and value for money as the department works towards delivering the 1% operational standard for six week waits for diagnostic tests.