NHS England has rowed back on what was widely understood to be a new target for the proportion of patients it wanted “diverted” away from waiting lists, after accusations it was rationing care.
The controversy surrounds how NHS England plans to ramp up the “advice and guidance” (A&G) model, which allows GPs to seek pre-referral advice from specialist clinicians, and is designed in part to reduce referrals.
NHSE guidance published just last month said it would roll out a new model involving a “single point of access” (SPoA), that would “contribute to a diversion rate of at least 25% by March 2027 for at least 10 high volume specialties” in each area.
Diverted patients are those who, after the A&G process, are managed in primary or community care instead of being put on the waiting list for secondary care.
The guidance was widely interpreted as a 25% diversion rate target for these cohorts of patients. This sparked concern and vocal opposition among GP leaders and patient groups, and accusations of care rationing.
However, in a letter to primary care issued late on Wednesday, NHSE said: “There is no national target for specialists, trusts or general practice to divert a fixed proportion of referrals away from hospital care.”
Source: HSJ, 22 April 2026
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