Patients get care closer to home as GP scheme expanded
Source: gov.uk (2025-04-16)

Government confirms expansion of Advice and Guidance scheme, with more patients now receiving their care closer to home.

- More patients to get care in the community thanks to rollout of expanded scheme to keep patients off waiting lists
- £80 million available to support GPs in getting patients care in the right place, rather than being sent to hospitals
- Expanded scheme marks latest step to deliver government’s Plan for Change to cut waiting lists after data shows 3 million extra appointments created since July
Tens of thousands of patients are receiving care closer to home, so they do not have to be added to lengthy NHS waiting lists, as the government confirms the expansion of a GP scheme to shift care from hospital to community.

The Advice and Guidance (https://www.england.nhs.uk/elective-care/best-practice-solutions/advice-and-guidance/) scheme sees GPs working more closely with hospital specialists to access expert advice quickly and speed their patients through the system, so they get care in the right place as soon as possible.

This means patients are being directed to more appropriate care - such as being prescribed medication, accessing blood tests or scans through their GP, or receiving care in a local women’s health hub or community physio service - rather than being put on long NHS waiting lists.

And new data shows that, between July and December 2024, around 660,000 treatments were diverted from hospitals and into the community thanks to the scheme - a 60,000 increase on the same period the previous year.

The government has pledged to expand the use of the system, with an ambition to increase diversions from the elective waiting list to up to 2 million by the end of 2025 to 2026 - meaning that more patients will benefit from faster and more convenient care. The NHS is now rolling out payments to GPs across the country, replacing the previous approach, which led to patchy provision and meant a postcode lottery for patients.

As a result of tough but necessary decisions made at the Autumn Budget 2024 (https://www.gov.uk/government/publications/autumn-budget-2024), the government has been able to put £26 billion of investment into the NHS, which is funding the £80 million expansion of this efficient and effective Advice and Guidance service - alongside driving forward work to cut waiting lists and improve care for patients through the Plan for Change (https://www.gov.uk/missions).

Thanks to the scheme, patients suffering from something as common as irritable bowel syndrome - which is estimated to affect up to 1 in 5 people - can avoid being added to already long waiting lists, which stand at almost 400,000 for digestive conditions. Instead, after an initial consultation between the patient and their family doctor, the GP can seek expert advice and refer the patient directly to dietitians to provide quicker care closer to home - all without the patient having to set foot inside a hospital.

Health Minister Karin Smyth said:

By caring for patients closer to home, we save time and stop masses of people having to head to hospital for unnecessary appointments in the first place.

We are rewiring the NHS so that we are doing things differently, more efficiently and delivering better outcomes for patients. This scheme is a perfect example of how we are saving patients time and reducing pressure on key NHS services in the process.

It will take time to reverse the damaging neglect the NHS has suffered in recent years, but our Plan for Change is starting to deliver benefits for patients, with waiting lists cut by 219,000 since July, and 1,500 new GPs in post.

Dr Amanda Doyle, NHS National Director for Primary Care and Community Services, said:

GPs have been working closely with specialist hospital teams to make sure patients get the right care and treatment.

Expanding this service with this new funding will help even more patients access the right support closer to their home while reducing unnecessary waits for hospital care.

Advice and Guidance opens a channel between GPs and hospital specialists before patients are referred onto waiting lists for hospital care. It enables patients to get the right tests and treatment through their GP or local services within their community.

From April 2025, GP practices can now claim for every request raised through the scheme in recognition of their vital role in helping to deliver the shift from hospital to community. The expansion of the scheme aims to standardise its use across the country and ensure it is being deployed consistently to get patients treated in the right place.

Many patients suffering from certain conditions can and should be safely and effectively managed in an out-of-hospital setting. This means people can take more power over decision making, which can help to improve overall wellbeing and potentially even reduce healthcare costs.

Other examples of patients who stand to benefit from the expansion include:
- women seeking gynaecological care, including treatment for menopause symptoms where GPs may need specialist advice on which types of hormone replacement therapy (HRT) to prescribe. Providing this treatment in the community saves patients being added to the waiting list for gynaecological care, which stands at more than 580,000
- patients with ear, nose and throat (ENT) issues - 30% of referrals to secondary care currently include many conditions that can and should be managed in an out-of-hospital setting, including tinnitus, ear wax removal and simple ear infections. As of February 2025, the waiting list for ENT services is 634,000
Professor Sir Sam Everington OBE, GP in Tower Hamlets since 1989, said:

Advice and Guidance enables patients and GPs to get advice direct from a specialist, typically within a week for routine cases. This means that patients get their health problems sorted rapidly, preventing health deterioration and avoiding long waits to be seen.

In my experience, over two-thirds of patients with kidney disease can be managed in this way with advice from a consultant and treatment by the GP, removing the enormous stress and uncertainty of waiting a long time.

Ruth Rankine, Director of Primary Care at the NHS Confederation, said:

Advice and Guidance, if implemented effectively, can support improved patient care, streamlined referrals processes and efficient use of resources. It can give the patient and their GP more control over their treatment options and support care closer to home.

For many conditions, we know that hospital treatment isn’t the best option so this measure will support a greater drive to provision of out-of-hospital services in line with the government’s priorities, and deliver more investment in primary and community services to provide more cost-effective support to patients.

Sharon Brennan, Director of Policy and External Affairs at National Voices, said:

If genuine shared decision making sits at the centre of the Advice and Guidance service, it has the potential to ensure, where appropriate, patients receive the most suitable care closer to home without having to anxiously sit on consultant waiting lists.

To make sure patients develop trust in this new service, we must see real choice offered to patients about what the best treatment routes are, and strong communication about what the service is and what it means in practical terms for patient care.

The government has set out its plan to reform and rebuild the NHS, with the ambition that 92% of patients will be waiting less than 18 weeks by the end of this Parliament.

The Plan for Change is already delivering tangible impacts for patients - with industrial action ended, NHS waiting lists falling and over 3 million additional appointments delivered since July 2024.

We have also begun fixing the front door of the NHS, hiring an extra 1,500 GPs since October 2024 and changing the GP contract to help bring an end to the 8am scramble for appointments.