Tech problem delays elective reform target

Concerns have been raised about NHS England watering down a key target for its controversial “advice and guidance” scheme, just weeks ahead of the October deadline.

The fears surround plans to create “single points of access” for all primary care requests, other than urgent suspected cancers, which trusts were set a target to introduce for 10 specialties by next month.

Instead of GPs routing referrals and A&G requests (where they get advice from a specialist) separately, the SPoA model is meant to send all requests via a single route, which NHSE believes will help reduce avoidable referrals and outpatient appointments.

However, upgrades to the e-Referral System have been delayed, and NHSE has been forced to allow trusts to go live with incomplete SPoA models.

Under an interim arrangement, A&G requests and referrals can enter the same SPoA service, but will arrive through separate e-RS routes, and will have to be managed on separate worklists, which experts said “appear to introduce fairly significant compromises”.

Interoperability problems with the e-RS, which make it harder to share clinical information and track patients through pathways, were also identified in a recent report by the Health Services Safety Investigations Body.

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Source: HSJ, 18 September 2026