Responding to a report from the Health Services Safety Investigations Body (HSSIB) into the “advice and guidance” process, which revealed evidence of patient harm and near misses, Dr Clare Bannon, BMA GP committee chair, said:

“Since its introduction, GPs have expressed deep concern with the advice and guidance system – we know our patients and know when a referral needs to be made. So this report is tragic vindication for these concerns, now showing that patients have come to harm as a result of this rushed-out and inconsistently-applied process.

“Just this week we had GPs telling a survey that a quarter of referrals were being sent back as advice and guidance, while genuine advice and guidance requests were taking 10 days or more for a response. We know the pressures our colleagues in secondary care are facing and it’s clear that this process is not working for either of us, nor our patients.

“The HSSIB is right to recommend an urgent evaluation of the advice and guidance system to address these clear patient safety risks.”

BMA consultants committee co-chairs Dr Shanu Datta and Dr Helen Neary added:

“With increasing demand and workforce shortages in both hospitals and GP practices, it’s clear that we need proper resourcing for staff, not barriers to patients getting the care they need just to artificially keep down waiting lists. That patients have come to harm should be a wake-up call to NHS bosses.

“We share our GP colleagues’ deep concern about the advice and guidance process, which was introduced against the wishes of consultants, who have worked collaboratively for decades with GPs to manage referrals when patients need specialist care.

“Too often advice and guidance has not been factored into consultants’ job plans, meaning they are having to fit this in outside of their working hours or during busy on-call periods. And time set aside for consultants to improve and innovate services, including strengthening links between primary and secondary care, has been continuously stripped away.

“Meanwhile, we continue to struggle with IT systems in hospitals that simply do not ‘talk to’ those in general practice.

“NHS England and DHSC must listen to the HSSIB’s warnings and follow-through with the recommended rapid review into this policy.”

Ends

Notes to editors

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.