NHS recently introduced the NHS England Advice & Guidance (A&G) incentive that aligns closely with Referral Support Services (RSS), as both aim to improve referral quality, reduce unnecessary hospital attendances, and ensure patients get the right care, when they need it. They both offer:

1. Shared Objective: Reducing Unnecessary Referrals

• Both A&G and RSS aim to reduce inappropriate or avoidable secondary care referrals by providing GPs with early access to specialist input or structured referral criteria.
• A&G helps clinicians resolve issues without sending the patient to hospital; RSS helps ensure that if a referral is made, it’s appropriate and complete.

2. Improving Patient Experience and Access

• A&G and RSS allow patients to be managed in primary care with specialist oversight, improving speed and convenience.
• They also ensure that patients who do need secondary care are referred appropriately and can be triaged or directed efficiently — often preventing delays due to incomplete or unclear referrals.

3. Supporting Clinical Decision-Making

• A&G gives support to GPs from hospital consultants that saves time for practice by offering a quicker response.
• RSS often provides structured templates or triage processes that help GPs decide whether referral is needed and how urgent it is.

4. Integration with Wider System Goals

• Both support integrated care system (ICS) aims of shifting care closer to home and reducing elective care backlogs.
• These tools complement other programmes like Pharmacy First and digital triage, helping practices manage demand more effectively and safely.

5. Financial and Operational Incentives

• A&G is now incentivised (£20 per use) and is offered as an enhanced service for 2025/2026.
• RSS often supports practices operationally by improving referral workflow and reducing time spent on rejected or bounced-back referrals.

Benefits to the practice:

• streamlined efficient referral processes, freeing–up administrative resource
• support and advice for clinicians and admin staff at the point of referral
• peer review and support from Secondary Care clinicians
• information / advice available regarding complex management and referral pathways
• local referral pathway information available via web link +/- DXS
• shadowing opportunities (particularly helpful for training new staff / consistency)

Benefits to patients:

• they are assessed, investigated, and treated by the right person, at the right place and at the right time
• use of increasing number of local community services, providing investigation and care closer to home for more patients
• reduced number of outpatient appointments which could have been covered in Primary Care
• supportive point of contact for referral and booking queries