A&G initiatives have potential to support patient care but need to work for everyone involved

Responding to a survey by Pulse of 712 GPs who estimated around a quarter of their attempted referrals to secondary care were being returned as unsolicited Advice and Guidance (A&G), Dr Munro Stewart, Vice President of the Royal College of GPs, said: “GPs understand the pressures facing colleagues in specialist care, so we won’t refer without good reason. As such, it’s vital that when we do these are taken seriously - especially when relating to potentially serious conditions, such as cancers - and our clinical expertise in identifying that a referral is appropriate is acknowledged. 

Advice and Guidance services have a place in the interface between primary and secondary care with the potential to support GPs, specialist colleagues and patients. But they shouldn’t be used as a way of rejecting referrals that GPs have deemed necessary, or to inadvertently shift care into general practice inappropriately or without appropriate resource.

“We want A&G to work, both in terms of supporting GPs to refer appropriately and to deliver care to patients whilst they are waiting for specialist treatment. As such, it’s important that polls such as this and other feedback from frontline clinicians in both primary and secondary care are taken on board as part of wider evaluation, so that issues can be identified and addressed.”

The College has also responded to a survey by the Royal College of Physicians looking at the impact of A&G on doctors working in secondary care.

Dr Munro Stewart, Vice President of the Royal College of GPs, said: "The aspirations behind Advice and Guidance services are good. They have the potential to support GPs to refer appropriately and deliver care to patients whilst they are waiting for specialist treatment.

“But A&G systems need to work for everyone involved. This poll shows that specialist doctors are finding the process frustrating, especially without the time or training to implement it effectively. And the College has spoken out previously about frustrations GPs are having, such as how A&G can be used to reject necessary referrals, or inadvertently shift care into general practice inappropriately or without appropriate resource.

“A&G services have potential to support GPs, specialist colleagues and patients, but they need to be implemented properly. As such, it’s important that polls such as this and other feedback from frontline clinicians in both primary and secondary care are taken on board as part of wider evaluation, so that issues can be identified and addressed.”

Further information

RCGP press office: 0203 188 7659

press@rcgp.org.uk

Notes to editors

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.