NHS England: Advice and Guidance – operational delivery framework for integrated care boards for 2025/26

Summary

The government priority is to return to the 18-week referral to treatment (RTT) standard through reforming elective care by March 2029. In support of this, NHS England has published a plan for reforming elective care for patients, setting out 4 key priority areas.

Care in the right place is one of the 4 areas, which includes Advice and Guidance (A&G) services and clinical triage of referrals. Advice and Guidance aims to ensure patients receive optimal care, as quickly as possible, in the most appropriate care setting while upholding patients’ rights to choice.

The Enhanced Service Specification sets out the requirements for payment of pre- referral Advice and Guidance requests. There is considerable variation in how Advice and Guidance is applied, delivered and monitored. It is important to manage patient demand, so a higher degree of rigour and standardisation is needed.

This framework has been created as a tool to support ICBs to ensure Advice and Guidance is implemented effectively. This approach will enable them to embed Advice and Guidance in their leadership, culture, operational processes and build on existing good practice in line with NHS IMPACT.

The framework has been co-produced, including input from a focus group of NHS colleagues from regions, ICBs, primary care and secondary care providers.