NHSE bid to divert referrals falling well short of target

NHS England is set to fall “well short” of a key target to ramp up GPs’ use of “advice and guidance” from specialists – and the model is “unlikely to be the silver bullet ministers hoped for” to help cut waiting lists, experts have warned.

The warning comes in a Nuffield Trust analysis, shared exclusively with HSJ. It represents a blow for ministers and NHS leaders because reducing referrals through an expansion of A&G is one of the central planks of their elective recovery plan.

The findings raise further questions about the NHS’s attempts to meet the government’s headline target of recovering 18-week performance back to the 92 per cent standard by 2029, which is already widely viewed to be off track.

The A&G model, when working well, allows GPs to seek advice from hospital specialists on a patient’s condition before making a referral. And in around half of these cases, the GP can avoid referring the patient onto the waiting list. This is known as a “diversion” – although the report explains that some of these cases would never have resulted in referrals.

But the analysis concludes that, while A&G requests have increased, the NHS will not deliver nearly enough requests overall, or “divert” enough referrals, to meet its ambitious targets.

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Source: HSJ, 27 February 2026