General Practitioners: Contracts
The question
To ask the Secretary of State for Health and Social Care, with reference to his Department's publication entitled Changes to the GP contract in 2026/27, updated on 4 March 2025, at what point during the process of advice and guidance will his Department add a patient to an official NHS waiting list.
Answered by Karin Smyth
Currently, a patient is added to an official waiting list when an Advice and Guidance request is converted into a referral. This will remain the case through part of 2026/27. From October 2026, expanded Advice and Guidance will be routed through a new Elective Single Point of Access (SPoA), in line with the Medium Term Planning Framework. From this point, while a patient will still be added onto a waiting list at the point of the referral being accepted, their waiting time will be calculated from the date the Advice and Guidance request or referral was received by the SpoA.
While advice is being sought and acted on in primary care, the general practitioner remains responsible for the patient’s overall clinical care and risk. The specialist is responsible for the quality and appropriateness of the advice they give, not for ongoing management or follow‑up unless they formally take the patient on. Specialist also have clinical responsibility from the point an Advice and Guidance request is converted into a referral or if the specialist initiates investigations or treatment directly.
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