NHS Standard Contract 2017-19 provisions

New requirements were added to the NHS Standard Contract 2017-19 to improve working practices between primary and secondary care. The expectation is on local GPs, through their CCG, to use the measures to hold hospitals to account for their performance.

A briefing document is available which describes the key national requirements that clinicians and managers are responsible for.

The joint letter from NHSEI was issued to CCG Accountable Officers, Chief Executives of NHS trusts and NHS foundation trusts.

A practical toolkit has been developed which includes guidance and case studies to support local collaboration and implementation of the contract requirements.


National guidance on responsibilities for prescribing between primary and secondary/tertiary care. This guidance aims to clarify the responsibilities of all professionals involved in commissioning and prescribing across primary, secondary and tertiary care, and to provide support in developing shared care agreements and in the transfer of care. The previous guidance (EL (91) 127) had last been published in 1991.

Onward referrals

Guidelines on best practice for onward referrals. This short clinical guidance document outlines clear principles for when patients can be referred onward without referral back to the GP

For patients

Patient leaflet explaining to patients what they can expect to happen if they are referred by their GP to see a specialist or consultant at a hospital or a community health centre.

Patient facing leaflet (colour)
Patient facing leaflet (black and white)

The leaflets are also available on the NHS website.

Accessible versions

Alternative languages