Since the COVID-19 pandemic, due to the large hospital waiting list backlog, the referral route from primary care (GPs) to secondary care (hospital specialists) has been changing. Rather than all patients referred by GPs being offered hospital clinic appointments, increasing numbers of hospital specialities are instead providing a service called Advice & Refer.

This means that, when a GP sends a referral, they may receive a reply from a hospital specialist with advice as to how best to manage the patient, such as patient information or advice, or alternative medication, instead of offering a clinic appointment. If so, your GP will contact you to inform you of this advice from the specialist.

If the specialist decides that you do need a clinic appointment, they will arrange this via the hospital. GPs have no control over the urgency of referrals or dates of any hospital appointment – this is decided by the hospital, but you can find information on how to chase up your referral or hospital appointment here.

The GP does get a choice over whether the specialist decides to send advice or to offer a clinic appointment.

Most hospital specialities are now using Advice & Refer. Currently, these include:

•  Allergy
• Cardiology
• Dermatology [photos required for all referrals]
• Diabetic Medicine
• Ear, Nose & Throat
• Elderly Care/Geriatrics
• Endocrinology
• Gastroenterology
• General Surgery
• Gynaecology
• Haematology
• Immunology
• Liver Medicine
• Liver Surgery
• Lower Gastrointestinal Surgery
• Nephrology
• Neurology
• Oral & Maxillofacial Surgery
• Paediatric Dermatology
• Pain Management
• Plastic Surgery
• Respiratory Medicine
• Rheumatology
• Sexual Health/Genitourinary Medicine
• Sleep Medicine
• Trauma & Orthopaedics
• Upper Gastrointestinal Surgery
• Vascular Surgery