A&G set for ‘broader adoption’ next year, says NHS England director

NHS England is expecting a ‘broader adoption’ of advice and guidance (A&G) next year, although it is unclear whether it has plans to mandate the use of A&G for all specialties.

During a meeting today, NHS England’s board responded to a question on whether it has plans to mandate the use of A&G as a requirement for GP referrals before April 2027, with a request for ‘details on the intended scope, timeline and guiding principles of any such mandate’.

Mark Cubbon, national priority programme director for planned care, did not respond directly on whether NHSE has plans to mandate the use of A&G, but said that subject to ‘digital tools’ making GP-hospital communication improving, there would be a ‘significant rollout’ of its ‘broader adoption’.

The NHS England medium-term planning document, published in October, asked general practice to prepare to move all referrals via A&G for the top 10 specialties with ‘the most potential for this model to be effective’ in 2026/27. 

Mr Cubbon said: ‘What we expect to see is a phased implementation next year. Once we’ve got the digital tools available to support referral process and the communication between GPs seamlessly as possible and hospital consultants, we expect to see a significant rollout of that next year for that broader adoption. 

‘It hasn’t been mandated to date. The only thing we’re mandating is essentially the top 10 specialties, and we’ll assess the impact throughout the year to see what we do next.’ 

The medium-term planning document said A&G expansion would be key in its goal to return to the ‘constitutional standard’ of 92% of patients waiting less than 18 weeks for treatment. 

During the meeting, NHSE primary care director Dr Amanda Doyle also gave some hints as to the content of the 2026/27 GP contract – consultations on which have recently concluded.

She said the next GP contract would ‘strengthen the focus’ on improving diabetes checks and MMR vaccination rates in children. 

Dr Doyle said: ‘We have taken action on … children’s vaccination rates, but also all eight diabetes care processes, to strengthen the focus on that within the GP contract. 

‘I can’t talk about details because they are not in the public domain for another couple of weeks, but we’ve noted it and acted.’  

It comes as the UK last month lost its measles elimination status, after the 2024 outbreak of almost 3,000 cases which caused officials to declare a public health incident. 

Last year, UK Health Security Agency Data revealed uptake rates for all main booster jabs for children under five had continued to decrease in England.  

Also revealed during today’s board meeting was that NHS England intends to move towards creating a more ‘permissive environment’ for sharing data across the NHS. 

As part of its strategy on data transparency, it said it was advocating ‘working openly by default’, giving ‘open access to insights designed for the NHS (e.g. benchmarking tools) so that analysts, researchers and interested parties beyond the NHS can also support service improvements driven through openness and accountability’. 

The board papers championed the expansion of the federated data platform (FDP), now used in 93% of ICBs, as an example of data transparency.

The FDP, which intends to link together data from across NHS organisations to support both planning and direct care, will form part of the NHS single patient record, set to be available to patients via the NHS App by 2028.

Palantir – a data analytics company known for its work with US intelligence and security agencies – was awarded a £330m, seven-year contract in 2023 to deliver the FDP.

Last year, the BMA passed a motion at its annual representative meeting (ARM) urging the NHS to cut ties with the company – calling it ‘an unacceptable choice of partner’ to handle patient data.

This article was corrected on 26 February. The article previously attributed the quote on A&G to NHS England non-executive director Mark Bailie.